Differential Diagnosis for Vague Tender Lump to Left Pubic Tubercle Area
Single Most Likely Diagnosis
- Inguinal ligament strain or avulsion: This condition is likely given the location of the pain (left pubic tubercle area) and the fact that it's mostly palpable when standing, suggesting a mechanical or musculoskeletal issue exacerbated by posture or movement.
Other Likely Diagnoses
- Osteitis pubis: An inflammatory condition affecting the pubic symphysis, which could cause pain and tenderness in the area, especially if activities like running or kicking are involved.
- Pubic bone stress fracture: A stress fracture in the pubic bone could cause localized pain and tenderness, particularly if the patient has recently increased their physical activity.
- Adductor tendonitis or strain: Given the proximity of the adductor muscles to the pubic tubercle, inflammation or strain of these tendons could cause pain in the area.
Do Not Miss Diagnoses
- Testicular cancer with metastasis to the pubic bone: Although rare, testicular cancer can metastasize to bones, including the pubic bone, and cause localized pain and swelling.
- Osteomyelitis of the pubic bone: An infection of the bone that could cause pain, swelling, and tenderness, which might not always present with systemic signs of infection.
- Public bone metastasis from other cancers: Metastatic disease to the pubic bone from other primary cancers (e.g., prostate, breast) could cause localized pain and should be considered, especially in patients with a known history of cancer.
Rare Diagnoses
- Bursitis of the iliopectineal bursa: Although less common, inflammation of the bursa located near the pubic tubercle could cause localized pain and swelling.
- Avulsion fracture of the pubic tubercle: A rare injury where a fragment of bone is pulled off by a tendon or ligament, which could occur in the context of severe trauma or sudden contraction of the attached muscles.
- Ewing's sarcoma or other primary bone tumors: Rare bone cancers that could present with localized pain and swelling in the pubic area, though these would be uncommon and typically associated with more systemic symptoms or significant trauma.