Differential Diagnosis for 52-year-old Female with Left Hypochondrial Pain and Renal Angle Tenderness
Single Most Likely Diagnosis
- Urinary Tract Infection (UTI) or Pyelonephritis: The presence of blood in the urine (hematuria) and renal angle tenderness suggests an infection involving the upper urinary tract, which is consistent with pyelonephritis. The left hypochondrial pain can be referred pain from the left kidney.
Other Likely Diagnoses
- Nephrolithiasis (Kidney Stones): The combination of renal angle tenderness and hematuria is also suggestive of kidney stones, which can cause obstruction and pain.
- Renal Cyst or Tumor: Although less common, a cyst or tumor in the left kidney could cause localized pain and hematuria.
Do Not Miss Diagnoses
- Sepsis due to Pyelonephritis: If the infection is severe, it could lead to sepsis, a life-threatening condition that requires immediate attention.
- Renal Infarction: Although rare, a renal infarction (lack of blood flow to the kidney) could present with acute pain and hematuria.
- Ectopic Pregnancy (if pregnant): Although the patient's age makes pregnancy less likely, an ectopic pregnancy could present with abdominal pain and hematuria.
Rare Diagnoses
- Renal Vasculitis: Inflammatory conditions affecting the blood vessels of the kidney, such as vasculitis, could cause renal pain and hematuria but are less common.
- Renal Trauma: If there's a history of recent trauma, a renal injury could be considered, although the presentation might be more acute.
- Metastatic Disease to the Kidney: In patients with a history of cancer, metastasis to the kidney could cause pain and hematuria, but this would be less common and dependent on the patient's medical history.