Differential Diagnosis for Right Upper Quadrant (RUQ) Pain
- Single Most Likely Diagnosis
- Gallbladder disease (cholecystitis or cholelithiasis): This is often the most common cause of RUQ pain, especially in females, due to the high prevalence of gallstones.
- Other Likely Diagnoses
- Peptic ulcer disease: Both gastric and duodenal ulcers can cause RUQ pain, especially if the ulcers are located in the duodenum or if there is associated inflammation.
- Hepatitis: Inflammation of the liver can cause RUQ pain, and it can be due to viral, alcoholic, or autoimmune causes.
- Biliary dyskinesia: A motility disorder of the gallbladder that can cause recurrent RUQ pain, often without evidence of gallstones.
- Do Not Miss Diagnoses
- Acute cholecystitis with perforation: A serious complication of gallbladder disease that requires immediate surgical intervention.
- Liver abscess: A rare but potentially life-threatening condition that requires prompt diagnosis and treatment.
- Hepatic artery aneurysm or rupture: A rare but catastrophic condition that can cause severe RUQ pain and requires immediate intervention.
- Pancreatitis: Although more commonly associated with mid-abdominal pain, pancreatitis can sometimes cause RUQ pain, especially if the pancreatic head is involved.
- Rare Diagnoses
- Fitz-Hugh-Curtis syndrome: A rare condition characterized by inflammation of the liver capsule and adjacent peritoneal surfaces, often due to pelvic inflammatory disease.
- Hepatocellular carcinoma: A rare cause of RUQ pain, but it should be considered in patients with risk factors such as cirrhosis or hepatitis B/C infection.
- Congenital anomalies of the biliary tree: Rare conditions such as choledochal cysts or Caroli's disease can cause RUQ pain and require specialized diagnosis and treatment.