Differential Diagnosis for Abdominal Pain Radiating to Lower Limb in Adults
Single Most Likely Diagnosis
- Lumbosacral Radiculopathy: This condition, often due to a herniated disk, can cause abdominal pain that radiates to the lower limb due to nerve root irritation. The pain typically follows a dermatomal distribution, making it a common cause of referred pain to the lower limb from the abdomen.
Other Likely Diagnoses
- Nephrolithiasis (Kidney Stones): Pain from kidney stones can start in the abdomen and radiate to the groin or lower limb, especially if the stone is moving down the ureter. The pain is often severe and can be accompanied by nausea, vomiting, and urinary symptoms.
- Diverticulitis: Inflammation of a diverticulum in the colon can cause abdominal pain, which may radiate to the lower limb, especially if the inflammation involves adjacent structures or nerves.
- Ovarian Cysts or Torsion: In women, ovarian cysts or torsion can cause severe abdominal pain that may radiate to the lower limb due to the involvement of pelvic nerves.
Do Not Miss Diagnoses
- Aortic Aneurysm or Dissection: Although less common, an abdominal aortic aneurysm or dissection can cause severe abdominal pain that radiates to the back or lower limbs. This is a medical emergency that requires immediate attention.
- Ectopic Pregnancy: In women of childbearing age, an ectopic pregnancy can cause abdominal pain that may radiate to the lower limb. This condition is life-threatening and requires prompt diagnosis and treatment.
- Appendicitis: While appendicitis typically causes pain localized to the right lower quadrant, in some cases, especially if the appendix is retrocecal, the pain can radiate to the lower limb.
Rare Diagnoses
- Psoas Abscess: An abscess in the psoas muscle can cause abdominal pain that radiates to the lower limb due to the involvement of the femoral nerve. This condition is rare but can be seen in patients with underlying infections or spinal conditions.
- Intra-abdominal Testicular Torsion: In rare cases, an intra-abdominal testis can undergo torsion, causing severe abdominal pain that may radiate to the lower limb.
- Retroperitoneal Hematoma or Tumor: Bleeding or a tumor in the retroperitoneal space can cause abdominal pain that radiates to the lower limb due to compression or involvement of adjacent nerves and structures.