Differential Diagnosis for Pelvic and Lower Back Pain in a 76-year-old
Single Most Likely Diagnosis
- Degenerative Joint Disease (Osteoarthritis): Given the patient's age, osteoarthritis is a common condition that can cause pelvic and lower back pain due to wear and tear of the joints. The pain is likely exacerbated by movement and relieved by rest.
Other Likely Diagnoses
- Musculoskeletal Strain: A common cause of pelvic and lower back pain, especially in older adults, due to decreased muscle mass and flexibility.
- Herniated Lumbar Disc: Age-related degeneration of the spinal discs can lead to herniation, causing pain in the lower back and pelvis.
- Osteoporotic Compression Fracture: Weakened bones in older adults can lead to compression fractures, which may cause sudden onset of pelvic and lower back pain.
Do Not Miss Diagnoses
- Abdominal Aortic Aneurysm (AAA): Although less likely, AAA is a life-threatening condition that can cause lower back and pelvic pain, especially if it is leaking or ruptured.
- Kidney Stones: Severe pain in the lower back and pelvis can be a symptom of kidney stones, which require prompt medical attention.
- Spinal Infection (Osteomyelitis or Discitis): Infections of the spine can cause severe pain and require early diagnosis and treatment to prevent serious complications.
- Cauda Equina Syndrome: A rare but serious condition caused by compression of the spinal nerves, which can lead to loss of bladder and bowel function if not promptly treated.
Rare Diagnoses
- Paget's Disease of Bone: A rare condition that can cause bone pain, including pelvic and lower back pain, due to abnormal bone remodeling.
- Metastatic Cancer: Although less common, cancer that has spread to the bones can cause pelvic and lower back pain, especially in older adults with a history of cancer.
- Sacroiliitis: Inflammation of the sacroiliac joints can cause pelvic and lower back pain, often associated with inflammatory conditions such as ankylosing spondylitis.