What is the cause of gluteal cleft pain in a 14-year-old female, without evidence of coccyx injury or pineal (pineal gland) cyst?

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Differential Diagnosis for Gluteal Cleft Pain in a 14-Year-Old Female

Single Most Likely Diagnosis

  • Pilondial sinus or cyst: This condition is a common cause of gluteal cleft pain, especially in adolescents. It occurs when a small pit or tunnel in the skin becomes infected, leading to pain, swelling, and sometimes discharge.

Other Likely Diagnoses

  • Furuncle or carbuncle: These are types of skin infections that can occur in the gluteal cleft, causing pain, redness, and swelling.
  • Gluteal cleft abscess: An abscess is a collection of pus that can form in the gluteal cleft, leading to severe pain and swelling.
  • Perianal abscess: Although the pain is localized to the gluteal cleft, a perianal abscess can sometimes cause referred pain to this area.

Do Not Miss Diagnoses

  • Appendicitis: Although the pain is typically localized to the right lower quadrant, appendicitis can sometimes present with pain in the gluteal cleft, especially if the appendix is retrocecal.
  • Ectopic pregnancy: In adolescent females, ectopic pregnancy is a life-threatening condition that can cause lower abdominal or gluteal cleft pain.
  • Ovarian torsion: This is a rare but serious condition that can cause severe pain in the lower abdomen or gluteal cleft.

Rare Diagnoses

  • Tarlov cyst: A rare type of cyst that can form in the nerve roots of the spine, causing pain in the gluteal cleft.
  • Gluteal cleft lipoma: A benign tumor that can cause pain and swelling in the gluteal cleft.
  • Levator ani syndrome: A rare condition that causes chronic pain in the gluteal cleft due to spasms of the levator ani muscle.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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