Differential Diagnosis for Flank Pain
The patient presents with dull flank pain, mostly on the left side, radiating to the back and occasionally the right side, accompanied by fatigue. The following differential diagnosis is organized into categories:
- Single most likely diagnosis:
- Musculoskeletal strain: The patient recently started using a rebounder trampoline for lymph drainage, which could have caused a musculoskeletal strain, leading to the flank pain. The fact that the pain is dull and radiates to the back supports this diagnosis.
- Other Likely diagnoses:
- Constipation: Although not explicitly mentioned, constipation can cause flank pain, especially if the patient has changed her diet or exercise routine.
- Gastrointestinal issues: Conditions like irritable bowel syndrome (IBS) or inflammatory bowel disease (IBD) can cause flank pain, although other symptoms like changes in bowel habits or abdominal pain would be expected.
- Adrenal gland disorders: Adrenal gland issues, such as adrenal insufficiency or hyperplasia, can cause flank pain, but other symptoms like changes in blood pressure, electrolyte imbalances, or hormonal changes would be expected.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
- Kidney cancer or other renal tumors: Although the kidney ultrasound was normal, it's essential to consider the possibility of a renal tumor, especially if the pain persists.
- Pulmonary embolism: Although the patient has no fever or other symptoms, a pulmonary embolism can cause flank pain, especially if it's related to a blood clot in the lungs.
- Aortic dissection or aneurysm: A tear or dilation of the aorta can cause severe flank pain, and it's crucial to rule out this life-threatening condition.
- Rare diagnoses:
- Pheochromocytoma: A rare tumor of the adrenal gland that can cause episodic flank pain, hypertension, and other symptoms.
- Retroperitoneal fibrosis: A rare condition characterized by the formation of fibrotic tissue in the retroperitoneum, which can cause flank pain and other symptoms.
- Sarcoidosis: A rare autoimmune disease that can cause flank pain, among other symptoms, due to granulomatous inflammation in various organs, including the kidneys.