Differential Diagnosis for Left Side Pain, Urinary Symptoms, and Hematuria
Single Most Likely Diagnosis
- Nephrolithiasis (Kidney Stone): The combination of left side pain, hematuria (blood in urine), and urinary symptoms such as urgency and frequency strongly suggests a kidney stone. The pain is often severe and can radiate to the groin area. The presence of blood in the urine and the symptoms of peeing but not a lot, along with urgency and frequency, are classic for a stone obstructing the flow of urine.
Other Likely Diagnoses
- Urinary Tract Infection (UTI): Although the patient does not have fever or chills, a UTI could still be present, especially with symptoms of urgency, frequency, and hematuria. The left side pain could be related to pyelonephritis, an upper urinary tract infection.
- Pyelonephritis: This is an infection of the kidney, which could cause left side pain, especially if the infection is localized to the left kidney. However, the absence of fever and chills makes this less likely than a kidney stone.
- Cystitis: An infection of the bladder could cause urgency, frequency, and hematuria. The left side pain might be referred pain or due to a stone that has moved from the kidney to the bladder.
Do Not Miss Diagnoses
- Renal Cell Carcinoma: Although less likely, it's crucial not to miss a diagnosis of renal cell carcinoma, which can present with hematuria and flank pain. The absence of other symptoms does not rule out this diagnosis.
- Ureteropelvic Junction (UPJ) Obstruction: This condition involves a blockage of the ureter at the junction where it meets the renal pelvis and can cause severe flank pain and hematuria, especially if there is an associated stone or infection.
- Vascular Issues (e.g., Renal Artery Stenosis or Aneurysm): These conditions can cause flank pain and, in some cases, hematuria. They are less common but critical to diagnose due to their potential for severe complications.
Rare Diagnoses
- Sickle Cell Disease Crisis: Patients with sickle cell disease can experience severe pain crises, including flank pain due to sickling in the kidneys, which can also lead to hematuria.
- Tuberculosis of the Urinary Tract: This can cause a variety of urinary symptoms, including hematuria and flank pain, although it is relatively rare in many parts of the world.
- Renal Infarction: This is a rare condition where the blood supply to the kidney is interrupted, leading to tissue death. It can cause severe flank pain and hematuria.