Differential Diagnosis for Pelvic and Lower Back Pain in a 76 y/o Female
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 weakened muscles and decreased flexibility.
- Urinary Tract Infection (UTI): Older adults are more prone to UTIs, which can cause pelvic pain, dysuria, and frequency.
- Constipation: Constipation can cause pelvic discomfort and lower back pain, especially if the patient has a history of bowel issues.
Do Not Miss Diagnoses
- Ovarian Torsion: Although less common, ovarian torsion is a medical emergency that requires prompt attention. It can cause severe pelvic pain and is more likely in postmenopausal women.
- Appendicitis: Although appendicitis is more common in younger populations, it can occur at any age and may present with atypical symptoms in older adults, such as pelvic or lower back pain.
- Kidney Stones: Nephrolithiasis can cause severe pain that radiates to the lower back and pelvis, and is a condition that requires timely diagnosis and treatment.
- Spinal Fracture: Osteoporotic compression fractures can cause sudden onset of back pain and are more common in older adults, especially postmenopausal women.
Rare Diagnoses
- Endometriosis: Although rare in postmenopausal women, endometriosis can cause chronic pelvic pain and should be considered if other diagnoses are ruled out.
- Pelvic Inflammatory Disease (PID): PID is less common in older adults but can occur, especially if the patient has a history of sexually transmitted infections or recent pelvic procedures.
- Cauda Equina Syndrome: A rare condition caused by compression of the spinal nerves, which can cause severe lower back pain, numbness, and weakness in the legs.