Differential Diagnosis for 71 y/o Female with Left Groin Pain
Single Most Likely Diagnosis
- Diverticulitis: Given the patient's age and symptoms of left groin pain, which could be referred pain from the lower abdomen, diverticulitis is a plausible diagnosis. The nausea also supports this, as diverticulitis can cause significant gastrointestinal distress.
Other Likely Diagnoses
- Ovarian Cyst: Although less common in postmenopausal women, ovarian cysts can still occur and cause pain, especially if they rupture or torsion occurs.
- Kidney Stone: The pain from a kidney stone can radiate to the groin area, and nausea is a common accompanying symptom.
- Urinary Tract Infection (UTI): UTIs are common in older adults and can cause significant pain and nausea.
Do Not Miss Diagnoses
- Ectopic Pregnancy: Although unlikely given the patient's age, ectopic pregnancy is a life-threatening condition that must be considered in any female patient of childbearing age with abdominal pain, regardless of reported menstrual status.
- Appendicitis: Appendicitis can present with pain that initially is diffuse or in the upper abdomen and then localizes to the right lower quadrant, but atypical presentations can occur, especially in older adults.
- Ovarian Torsion: This is a surgical emergency that can cause severe pain and is more likely if the patient has a history of ovarian cysts or masses.
- Ruptured Abdominal Aortic Aneurysm (AAA): Although AAA typically presents with back or abdominal pain, it can radiate to the groin and is a life-threatening condition.
Rare Diagnoses
- Herpes Zoster (Shingles): Given the patient's history of herpes, it's possible that the pain could be related to a shingles outbreak, although the patient denies a current breakout. Shingles can cause significant pain before the rash appears.
- Endometriosis: Although rare in postmenopausal women, endometriosis can cause chronic pain and could potentially cause acute exacerbations.
- Lymphoma or Other Malignancies: Various cancers can cause abdominal or groin pain, either directly or through metastasis, and should be considered in the differential diagnosis, especially in older adults.