Differential Diagnosis for Lower Abdominal and Buttock Pain
The patient presents with pain in the lower abdomen and behind the buttocks, which could be indicative of several conditions. Here's a categorized differential diagnosis:
Single Most Likely Diagnosis
- Musculoskeletal strain: This is often the most common cause of lower abdominal and buttock pain, especially if the patient has recently engaged in physical activity or has a history of lifting heavy objects. The pain is usually localized and can be exacerbated by movement.
Other Likely Diagnoses
- Urinary tract infection (UTI): UTIs can cause lower abdominal pain and may radiate to the buttocks or groin area. Symptoms often include dysuria, frequency, and urgency.
- Constipation or fecal impaction: These conditions can cause significant pain in the lower abdomen and buttocks, especially if the patient is straining during bowel movements.
- Prostatitis (in males): Inflammation of the prostate gland can cause pain in the lower abdomen, buttocks, and groin area, often accompanied by urinary symptoms.
- Ovarian cysts or endometriosis (in females): These conditions can cause chronic or intermittent pain in the lower abdomen and buttocks, often related to menstrual cycles.
Do Not Miss Diagnoses
- Appendicitis: Although the pain typically starts near the navel and then moves to the lower right abdomen, some cases can present with pain in the lower abdomen and buttocks. It's crucial to consider this diagnosis due to the potential for severe complications if appendicitis ruptures.
- Kidney stones: Severe pain that radiates from the flank to the groin or buttocks can be a sign of kidney stones. The pain is often colicky and can be accompanied by nausea, vomiting, and urinary symptoms.
- Diverticulitis: Inflammation of the diverticula in the colon can cause severe pain in the lower abdomen, which may radiate to the buttocks. Fever, nausea, and changes in bowel habits may also be present.
- Ectopic pregnancy (in females): This is a life-threatening condition where a pregnancy develops outside the uterus, often causing severe abdominal pain and potentially radiating to the buttocks.
Rare Diagnoses
- Pudendal neuralgia: This condition involves pain along the pudendal nerve, which can cause pain in the buttocks, perineum, and genital area.
- Coccydynia: Pain in the coccyx (tailbone) can be caused by a fall or direct trauma and may radiate to the lower abdomen and buttocks.
- Spinal conditions (e.g., herniated disk, spinal stenosis): These can cause referred pain to the buttocks and lower abdomen, especially if there is nerve root compression.