Differential Diagnosis for Left Flank Pain without Urinary Symptoms
Single Most Likely Diagnosis
- Musculoskeletal strain: Given the absence of urinary symptoms, musculoskeletal strain is a common cause of flank pain, often resulting from overuse, poor posture, or direct injury to the muscles in the flank area.
Other Likely Diagnoses
- Nephrolithiasis (kidney stones) without obstruction: Although urinary symptoms are common, some patients with kidney stones may not exhibit typical symptoms like dysuria or frequent urination, especially if the stone is not obstructing the ureter.
- Pyelonephritis: An infection of the kidney that can cause flank pain, pyelonephritis might not always present with urinary symptoms, especially in its early stages or in individuals with compromised immune systems.
- Pancreatitis: Inflammation of the pancreas can cause severe abdominal pain that radiates to the flank area, and while it often presents with other symptoms like nausea and vomiting, these might not always be prominent.
Do Not Miss Diagnoses
- Abdominal aortic aneurysm: A potentially life-threatening condition where the aorta enlarges, which can cause flank pain. It is crucial to consider this diagnosis, especially in older patients or those with risk factors like smoking or hypertension.
- Pulmonary embolism: Although more commonly associated with chest pain and shortness of breath, in rare cases, a pulmonary embolism can refer pain to the flank area, making it a critical diagnosis not to miss.
- Retroperitoneal hemorrhage: Bleeding into the space behind the peritoneum can cause flank pain and is a medical emergency, often associated with trauma, anticoagulation, or vascular abnormalities.
Rare Diagnoses
- Splenic infarct: An infarct of the spleen can cause left flank pain and is more likely in patients with sickle cell disease, thrombocytosis, or other hypercoagulable states.
- Lymphoma: Certain types of lymphoma can cause flank pain due to the involvement of lymph nodes in the retroperitoneal space.
- Pheochromocytoma: A rare tumor of the adrenal gland that can cause episodic pain, including flank pain, along with other symptoms like hypertension and palpitations.