What is the diagnosis for a 23-year-old female with left lower quadrant (LLQ) abdominal pain that radiates down her left leg for the past 20 hours?

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Differential Diagnosis for 23yo Female with LLQ Abdo Pain Radiating Down Left Leg

  • Single Most Likely Diagnosis
    • Ovarian cyst or torsion: This is a common cause of lower abdominal pain in young women, especially when the pain radiates down the leg. The pain is often severe and can be accompanied by nausea and vomiting.
  • Other Likely Diagnoses
    • Constipation or bowel obstruction: Although less likely, constipation or a bowel obstruction could cause lower abdominal pain that radiates down the leg, especially if there is nerve involvement.
    • Urinary tract infection or kidney stone: A urinary tract infection or kidney stone could cause severe pain that radiates down the leg, especially if the stone is moving down the ureter.
    • Musculoskeletal strain: A strain or pull in the lower back or leg muscles could cause pain that radiates down the leg.
  • Do Not Miss Diagnoses
    • Ectopic pregnancy: Although the patient's age and symptoms do not strongly suggest pregnancy, an ectopic pregnancy can cause severe abdominal pain that radiates down the leg and can be life-threatening if not promptly diagnosed and treated.
    • Appendicitis: Although the pain is on the left side, appendicitis can occasionally present with pain on the left side, especially if the appendix is retrocecal. Appendicitis is a surgical emergency.
    • Diverticulitis: Diverticulitis can cause severe abdominal pain that radiates down the leg, especially if there is an abscess or perforation. This diagnosis is more common in older adults but can occur in younger individuals.
  • Rare Diagnoses
    • Endometriosis: Endometriosis can cause chronic pelvic pain that radiates down the leg, but it is less likely to cause acute, severe pain.
    • Inflammatory bowel disease: Inflammatory bowel disease, such as Crohn's disease or ulcerative colitis, can cause abdominal pain that radiates down the leg, but it is less common in this age group and would likely be accompanied by other symptoms such as diarrhea or weight loss.
    • Neurological disorders (e.g., sciatica, neuropathy): Neurological disorders can cause pain that radiates down the leg, but they would likely be accompanied by other neurological symptoms such as numbness, tingling, or weakness.

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.

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