Flank pain: Difference between revisions

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*[[Cullen's sign]]
*[[Cullen's sign]]


==Common Causes of Flank Pain==
==Causes==
 
===Common Causes===
*Disc disease
*Disc disease
*[[Herpes zoster]] or [[shingles]]
*[[Herpes zoster]] or [[shingles]]
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*[[Urinary tract infection]] (UTI)
*[[Urinary tract infection]] (UTI)


== Complete Differential Diagnosis of Flank Pain==
===Causes by Organ System===
{|style="width:82%; height:100px" border="1"
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular'''
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | No underlying causes
|-
|bgcolor="LightSteelBlue" | '''Chemical/Poisoning'''
|bgcolor="Beige" | No underlying causes
|-
|bgcolor="LightSteelBlue" | '''Dental'''
|bgcolor="Beige" | No underlying causes
|-
|bgcolor="LightSteelBlue" | '''Dermatologic'''
|bgcolor="Beige"| No underlying causes
|-
|bgcolor="LightSteelBlue" | '''Drug Side Effect'''
|bgcolor="Beige" | No underlying causes
|-
|bgcolor="LightSteelBlue" | '''Ear Nose Throat'''
|bgcolor="Beige" | No underlying causes
|-
|bgcolor="LightSteelBlue" | '''Endocrine'''
|bgcolor="Beige" | No underlying causes
|-
|bgcolor="LightSteelBlue" | '''Environmental'''
|bgcolor="Beige" | No underlying causes
|-
|bgcolor="LightSteelBlue" | '''Gastroenterologic'''
|bgcolor="Beige" | No underlying causes
|-
|bgcolor="LightSteelBlue" | '''Genetic'''
|bgcolor="Beige" | No underlying causes
|-
|bgcolor="LightSteelBlue" | '''Hematologic'''
|bgcolor="Beige" | No underlying causes
|-
|bgcolor="LightSteelBlue" | '''Iatrogenic'''
|bgcolor="Beige" | No underlying causes
|-
|bgcolor="LightSteelBlue" | '''Infectious Disease'''
|bgcolor="Beige" | No underlying causes
|-
|bgcolor="LightSteelBlue" | '''Musculoskeletal/Orthopedic'''
|bgcolor="Beige" | No underlying causes
|-
|bgcolor="LightSteelBlue" | '''Neurologic'''
|bgcolor="Beige" | No underlying causes
|-
|bgcolor="LightSteelBlue" | '''Nutritional/Metabolic'''
|bgcolor="Beige" | No underlying causes
|-
|bgcolor="LightSteelBlue" | '''Obstetric/Gynecologic'''
|bgcolor="Beige" | No underlying causes
|-
|bgcolor="LightSteelBlue" | '''Oncologic'''
|bgcolor="Beige" | No underlying causes
|-
|bgcolor="LightSteelBlue" | '''Ophthalmologic'''
|bgcolor="Beige" | No underlying causes
|-
|bgcolor="LightSteelBlue" | '''Overdose/Toxicity'''
|bgcolor="Beige" | No underlying causes
|-
|bgcolor="LightSteelBlue" | '''Psychiatric'''
|bgcolor="Beige" | No underlying causes
|-
|bgcolor="LightSteelBlue" | '''Pulmonary'''
|bgcolor="Beige" | No underlying causes
|-
|bgcolor="LightSteelBlue" | '''Renal/Electrolyte'''
|bgcolor="Beige" | No underlying causes
|-
|bgcolor="LightSteelBlue" | '''Rheumatology/Immunology/Allergy'''
|bgcolor="Beige" | No underlying causes
|-
|bgcolor="LightSteelBlue" | '''Sexual'''
|bgcolor="Beige" | No underlying causes
|-
|bgcolor="LightSteelBlue" | '''Trauma'''
|bgcolor="Beige" | No underlying causes
|-
|bgcolor="LightSteelBlue" | '''Urologic'''
|bgcolor="Beige" | No underlying causes
|-
|bgcolor="LightSteelBlue" | '''Miscellaneous'''
|bgcolor="Beige" | No underlying causes
|-
|}
===Causes in Alphabetical Order===
{{col-begin|width=84%}}
{{col-break|width=33%}}
{{col-break|width=33%}}
{{col-break|width=33%}}
{{col-end}}
 
== Differential Diagnosis of Flank Pain==


In alphabetical order. <ref>Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016</ref> <ref>Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X</ref>
In alphabetical order. <ref>Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016</ref> <ref>Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X</ref>

Revision as of 16:04, 17 July 2013

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Template:Editor help

Flank pain' is a discomfort that occurs in a region of the posterior torso (lower back) beneath the ribs and above the ilium

Symptoms

Characterization of the symptoms associated with flank pain may help in pinpointing the underlying etiology. Obviously, a thorough genitourinary history should be obtained since kidney disease is a common cause of flank pain. Care should be taken to characterize the exact location of the pain as well as if there is any radiation of the pain. Care should be taken to understand if the pain represents a form of colic in which case a diagnosis of either renal colic or biliary colic might be suggested. A history of other recent illnesses should be obtained as well.

Signs

Physical examination

A careful examination of the patient's flank should be undertaken.

Causes

Common Causes

Causes by Organ System

Cardiovascular No underlying causes
Chemical/Poisoning No underlying causes
Dental No underlying causes
Dermatologic No underlying causes
Drug Side Effect No underlying causes
Ear Nose Throat No underlying causes
Endocrine No underlying causes
Environmental No underlying causes
Gastroenterologic No underlying causes
Genetic No underlying causes
Hematologic No underlying causes
Iatrogenic No underlying causes
Infectious Disease No underlying causes
Musculoskeletal/Orthopedic No underlying causes
Neurologic No underlying causes
Nutritional/Metabolic No underlying causes
Obstetric/Gynecologic No underlying causes
Oncologic No underlying causes
Ophthalmologic No underlying causes
Overdose/Toxicity No underlying causes
Psychiatric No underlying causes
Pulmonary No underlying causes
Renal/Electrolyte No underlying causes
Rheumatology/Immunology/Allergy No underlying causes
Sexual No underlying causes
Trauma No underlying causes
Urologic No underlying causes
Miscellaneous No underlying causes

Causes in Alphabetical Order

Differential Diagnosis of Flank Pain

In alphabetical order. [1] [2]

Laboratory studies

  • Initial laboratory evaluation of flank pain should include an evaluation of common causes such as those originating in the genitourinary system. Thus a urinanalysis and urine culture and sensitivity are appropriate starting points. An appropriate imaging evaluation would include a renal ultrasound.
  • If musculoskeletal or disc disease is thought to be likely, then a lumbosacral x-ray or a lumbosacral MRI would be appropriate.
  • More extensive laboratory evaluation should be directed at the most likely underlying cause. If a gastrointestinal causes is suspected, then liver function tests and a serum amylase or lipase should be ordered.
  • If an infectious etiology is suspected, then a complete blood count and blood cultures should be ordered.
  • In a young woman of childbearing potential, a pregnancy test should be ordered.
  • In an elderly man or woman in whom bladder cancer is suspected then urine cytology may be an appropriate starting point as well.

References

  1. ↑ Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016
  2. ↑ Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X



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