Differential Diagnosis for 20 y/o Male with UC and Sudden Onset Left Middle Back Pain
- Single most likely diagnosis:
- Musculoskeletal strain: Given the sudden onset of back pain under the rib cage, a musculoskeletal strain is a common and likely cause, especially if the patient has been engaging in physical activity or has poor posture.
- Other Likely diagnoses:
- Kidney stone: The patient's history of ulcerative colitis (UC) increases the risk of kidney stones due to chronic inflammation and potential kidney damage. The location of the pain under the rib cage is consistent with a kidney stone.
- Costochondritis: Inflammation of the cartilage that connects the ribs to the breastbone can cause sharp pains in the chest or back, which may be exacerbated by the patient's UC.
- Pulmonary embolism (less likely due to stable vitals, but still a consideration): Although less likely given the patient's stable vitals, a pulmonary embolism can cause sudden onset back pain and should be considered, especially if the patient has a history of deep vein thrombosis or other risk factors.
- Do Not Miss diagnoses:
- Pneumothorax: A collapsed lung can cause sudden onset back pain and is a life-threatening condition that requires immediate attention.
- Aortic dissection: A tear in the aorta can cause severe back pain and is a medical emergency that requires prompt diagnosis and treatment.
- Sickle cell crisis (if applicable): If the patient has sickle cell disease, a crisis can cause severe back pain and requires immediate medical attention.
- Rare diagnoses:
- Osteomyelitis: An infection of the bone can cause back pain, but it is less common and typically associated with other symptoms such as fever and swelling.
- Spinal epidural abscess: A rare but serious condition that can cause back pain, fever, and neurological symptoms, requiring prompt medical attention.