What is the likely diagnosis for a 20-year-old female patient experiencing right-sided abdominal pain radiating to the hip area, with exacerbation during her menstrual cycle and a family history of inflammatory bowel disease (IBD), including Crohn's disease in her twin brother and ulcerative colitis in her younger brother?

Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Educational purpose only • Exercise caution as content is pending human review
Article Review Status
Submitted
Under Review
Approved

Last updated: April 14, 2025View editorial policy

Personalize

Help us tailor your experience

Which best describes you? Your choice helps us use language that's most understandable for you.

Differential Diagnosis for a 20-year-old Female with Abdominal Pain

Single Most Likely Diagnosis

  • Endometriosis: This condition is characterized by the presence of endometrial tissue outside the uterus, leading to chronic pelvic pain, dysmenorrhea (painful menstruation), and dyspareunia (painful intercourse). The patient's symptoms of pain radiating to the hip area, worsening with menstrual cycles, and increased cramps during periods are classic for endometriosis.

Other Likely Diagnoses

  • Irritable Bowel Syndrome (IBS): Given the family history of inflammatory bowel disease (Crohn's disease and ulcerative colitis), IBS could be considered, especially if the patient experiences changes in bowel habits along with abdominal pain. However, the specific pattern of pain related to menstrual cycles is less typical for IBS.
  • Ovarian Cysts: These can cause pelvic pain that may radiate to the hip area and can be influenced by the menstrual cycle, although they are usually more acute in presentation.
  • Pelvic Inflammatory Disease (PID): This is an infection of the female reproductive organs that can cause chronic pelvic pain, but it is often associated with other symptoms like abnormal vaginal discharge, fever, and pain during sexual intercourse.

Do Not Miss Diagnoses

  • Ectopic Pregnancy: Although less likely given the patient's age and the chronic nature of the pain, an ectopic pregnancy can present with abdominal pain radiating to the hip and can be life-threatening if not promptly diagnosed.
  • Appendicitis: While the pain of appendicitis typically starts near the navel and then moves to the lower right abdomen, atypical presentations can occur, and appendicitis is a surgical emergency.
  • Ovarian Torsion: This is a condition where the ovary twists around its ligaments, cutting off blood supply. It can cause severe, sudden pelvic pain and is a medical emergency.

Rare Diagnoses

  • Adenomyosis: A condition where tissue similar to the lining inside the uterus grows into the muscular walls of the uterus, leading to painful, heavy periods. It's less common in younger women.
  • Interstitial Cystitis: A condition causing bladder pressure, bladder pain, and sometimes pelvic pain. The symptoms can worsen with certain foods or drinks and can be influenced by the menstrual cycle, but it's less directly related to the menstrual cycle than endometriosis.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

Have a follow-up question?

Our Medical A.I. is used by practicing medical doctors at top research institutions around the world. Ask any follow up question and get world-class guideline-backed answers instantly.