Differential Diagnosis for Lower Abdominal Pain Referred to the Groin and Renal Tenderness
Single Most Likely Diagnosis
- Nephrolithiasis (Kidney Stones): This condition is a common cause of severe pain that can radiate from the lower back to the groin area, often accompanied by renal tenderness. The pain is typically colicky in nature, meaning it comes and goes in waves.
Other Likely Diagnoses
- Urinary Tract Infection (UTI): While more commonly associated with dysuria and frequency, a UTI can cause lower abdominal pain and renal tenderness, especially if it has ascended to the kidneys (pyelonephritis).
- Ovarian Cyst or Torsion: In females, ovarian cysts can cause lower abdominal pain that may radiate to the groin. If the cyst becomes twisted (torsion), the pain can become severe and acute.
- Appendicitis: Although classically presenting with right lower quadrant pain, appendicitis can sometimes cause pain that is more diffuse or lower in the abdomen, potentially radiating to the groin, especially if the appendix is located in a retrocecal position.
Do Not Miss Diagnoses
- Testicular Torsion: A medical emergency that requires immediate attention. It presents with sudden, severe testicular pain that can radiate to the groin and lower abdomen.
- Ectopic Pregnancy: Another emergency condition that can cause lower abdominal pain, potentially radiating to the groin, and is critical to diagnose early in pregnant women.
- Ruptured Aneurysm (Abdominal Aortic Aneurysm): Although less common, a ruptured AAA can cause severe, acute lower back and abdominal pain that may radiate to the groin, accompanied by signs of shock.
Rare Diagnoses
- Psoas Abscess: An abscess in the psoas muscle can cause lower abdominal and back pain that may radiate to the groin, often accompanied by fever and malaise.
- Retroperitoneal Hematoma or Fibrosis: These conditions can cause lower abdominal and back pain, potentially radiating to the groin, due to bleeding or fibrotic changes in the retroperitoneal space.
- Genitofemoral Neuralgia: A rare condition involving the genitofemoral nerve that can cause chronic pain in the lower abdomen, groin, and thigh.