Differential Diagnosis for Lower Abdominal Pain and Renal Angle Tenderness
Single Most Likely Diagnosis
- Nephrolithiasis (Kidney Stones): This condition is a common cause of severe pain, often presenting with renal angle tenderness and can radiate to the lower abdomen. The pain is typically colicky in nature and can be accompanied by nausea, vomiting, and hematuria.
Other Likely Diagnoses
- Pyelonephritis: An infection of the kidney, which can cause lower abdominal pain, renal angle tenderness, and systemic symptoms such as fever and chills.
- Urinary Tract Infection (UTI): While often causing dysuria and frequency, a UTI can also lead to lower abdominal pain and renal angle tenderness, especially if the infection ascends to the kidneys.
- Appendicitis: Although classically presenting with right lower quadrant pain, appendicitis can sometimes cause lower abdominal pain and tenderness that might be confused with renal angle pain, especially if the appendix is retrocecal.
Do Not Miss Diagnoses
- Ectopic Pregnancy: A life-threatening condition in women of childbearing age, presenting with lower abdominal pain and potentially renal angle tenderness due to referred pain. It's crucial to consider this diagnosis to avoid missing a potentially fatal condition.
- Ruptured Abdominal Aortic Aneurysm: Although more common in older adults with a history of hypertension or smoking, a ruptured AAA can present with severe lower back or abdominal pain and tenderness, which might be confused with renal angle pain.
- Ovarian Torsion: Another emergency condition, ovarian torsion can cause severe lower abdominal pain and might be associated with renal angle tenderness due to the proximity of the ovaries to the kidneys.
Rare Diagnoses
- Renal Cell Carcinoma: A type of kidney cancer that can cause a variety of symptoms including abdominal pain and a palpable mass, but it is much less common than other causes of renal angle tenderness.
- Polycystic Kidney Disease (PKD): An inherited disorder characterized by the growth of numerous cysts filled with fluid in the kidneys, which can cause chronic pain, renal angle tenderness, and other complications.
- Renal Infarction: A rare condition where the blood supply to the kidney is interrupted, leading to tissue death. It can present with acute onset of flank or abdominal pain and might be considered in the differential diagnosis of renal angle tenderness, especially in patients with risk factors for thromboembolism.