II. Differential Diagnosis

  1. Renal Causes
    1. Ureterolithiasis (60% of acute Flank Pain presentations)
    2. Pyelonephritis
    3. Renal Mass (e.g. Renal Cell Carcinoma)
    4. Renal Vein Thrombosis
    5. Renal Infarction
  2. Intraabdominal Cause
    1. Abdominal Aortic Aneurysm
      1. Represents 1-2% of Flank Pain presentations (often initially misdiagnosed as Renal Colic)
      2. Marston (1992) J Vasc Surg 16(1): 17-22 [PubMed]
    2. Small Bowel Obstruction
    3. Pancreatitis
    4. Ascites
  3. Right sided Flank Pain
    1. Cholecystitis or Biliary Colic (right sided Flank Pain)
    2. Appendicitis
    3. Peptic Ulcer Disease
  4. Referred pain from Pelvis
    1. Dysmenorrhea
    2. Ovarian Torsion
    3. Ectopic Pregnancy
    4. Ruptured Ovarian Cyst
    5. Testicular Torsion
  5. Referred pain from chest
    1. Pulmonary Embolism
    2. Pneumonia
    3. Rib Contusion or Rib Fracture
  6. Skin and Musculoskeletal
    1. Lumbar back pain (e.g. latisimus dorsi strain)
    2. Herpes Zoster

Images: Related links to external sites (from Bing)

Related Studies

Ontology: Flank Pain (C0016199)

Definition (NCI_CTCAE) A disorder characterized by marked discomfort sensation on the lateral side of the body in the region below the ribs and above the hip.
Definition (NCI) Painful sensation in the region below the ribs and above the hip.
Definition (MSH) Pain emanating from below the RIBS and above the ILIUM.
Concepts Sign or Symptom (T184)
MSH D021501
SnomedCT 139316002, 162045003, 267165003, 247355005
English FLANK PAIN, Flank Pain, pain in the flank, pain in flank (symptom), pain in flank, Pain flank, Flank Pain [Disease/Finding], pain flank, Pain;flank, flank pain, Pain, Flank, Pains, Flank, Flank Pains, Flank pain, Flank pain (finding), flank; pain, pain; flank
Dutch pijn in de flank, flank; pijn, pijn; flank, flankpijn, Pijn, flank-
German Seitenstiche, FLANKENSCHMERZ, Flankenschmerz
Portuguese Dor no flanco, DOR NO FLANCO, Dor de Flanco, Dor do flanco, Dor no Flanco
Swedish Flanksmärta
Japanese ソクフクブツウ, 側腹痛, 側腹部痛
Finnish Kylkikipu
Russian BOK, BOLI, БОК, БОЛИ
Spanish COSTADO, DOLOR, Dolor en el Flanco, Dolor en la Región Lateral, Dolor en el Costado, Dolor en la Región Abnominal Lateral, Dolor de Costado, Dolor de Flanco, dolor en el flanco (hallazgo), dolor en el flanco, Dolor en flanco
French DOULEUR DANS LE FLANC, Douleur du flanc
Czech Bolest v boku, bolest boku, bok - bolest, bolest v boku
Polish Ból w boku
Hungarian Lágyéki fájdalom, Fájdalom, lágyéktáj
Norwegian Flankesmerter, Flankesmerte
Italian Dolore al fianco

Ontology: Tenderness costovertebral angle (CVA) (C3842099)

Concepts Finding (T033)
LNC LA17257-9
English Tenderness costovertebral angle (CVA)