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FLANK PAIN

Most cases of flank pain are associated with inflammation of the kidney. As is shown in Table 29, however, jumping to that conclusion in any given case may be hazardous.


FLANK PAIN

TABLE 29. FLANK PAIN

 

V

I

N

D

I

C

A

T

E
 

Vascular

Inflammatory

Neoplasm

Degenerative

Intoxication Idiopathic

Congenital Acquired Malformation

Autoimmune

Trauma

Endocrine

Skin

  

Cellulitis

          

Contusion

  
   

Herpes zoster

          

Laceration

  

Muscle and Fascia

  

Trichinosis

      

Hernia

Dermatomyositis

Contusion

  

Colon

Mesenteric thrombosis

Colitis

Carcinoma

    

Diverticulitis

Ulcerative colitis

Contusion

  
           

Appendix

Granulomatous colitis

Laceration

  

Gallbladder

  

Cholecystitis

Carcinoma

            
   

Cholangitis

              

Adrenal Gland

                

Hemorrhage
                 

Infarction
                 

Tumor

Kidney

Embolism

Pyelonephritis

Wilm tumor

  

Gout

Obstruction

Periarteritis nodosa

Contusion

Calculus due to hyperparathyroidism
 

Thrombosis

Perinephric abscess

Hypernephroma

  

Toxic nephritis

Infection due to malformation

Vasculitis of other cause

Laceration

  
         

Crush syndrome

Aorta

Aneurysm

    

Atheroma

      

Rupture

  
       

Dissecting aneurysm

          

Vena Cava

Thrombosis

                

Spine

  

Osteomyelitis

Metastatic carcinoma

Osteoarthritis

    

Marie–Strümpell disease

Fracture

  
   

Tuberculosis

          

Herniated disc

  

Spinal Cord and Nerves

Anterior spinal artery occlusion

Tabes dorsalis

Spinal cord tumor

  

Arsenic poisoning

Syringomyelia

Guillain–Barré syndrome

Hematoma

  
   

Myelitis

  

Porphyria

          
   

Epidural abscess

              

In addition to the kidney (pyelonephritis and perinephric abscess), inflammation of the skin (herpes zoster), the colon (diverticulitis and colitis), the gallbladder (cholecystitis), and the spine (epidural abscess and Pott disease) may also cause flank pain. The mnemonic VINDICATE also suggests several vascular disorders that are significant causes of flank pain such as aortic aneurysms, embolic nephritis, and mesenteric thrombosis. Neoplasms of the kidney and colon are less likely to produce pain unless they are complicated by infection. However, trauma of the kidney and spine and renal calculi—whether due to hyperparathyroidism, idiopathic etiologies, or hyperuricemia—are important causes. Neoplasms of the spinal cord and tabes dorsalis must also be considered.

Approach to the Diagnosis

The diagnosis of flank pain usually involves careful examination of the urine and a urine culture, an IVP, and plain films of the abdomen and spine. If these are negative, bone scans, arteriogram, and other tests listed below may be required. CT has eliminated the need for exploratory laparotomy in many cases.

Other Useful Tests

  1. Urology consult
  2. Neurology consult
  3. CBC
  4. Chemistry panel (uremia, renal calculi)
  5. CT scan of the abdomen and pelvis (neoplasms, stones, hemorrhage abscess)
  6. X-rays of the thoracolumbar spine (bone metastasis, herniated disc)
  7. MRI of the thoracic spine (neoplasms, herniated disc)
  8. Sonogram (renal cyst)
  9. Urine for AFB smear and culture (tuberculosis)
  10. Cystoscopy and retrograde pyelography (malformations, neoplasm)
  11. Protein electrophoresis (multiple myeloma)

Book Source Details

  • Book Title: Differential Diagnosis in Primary Care
  • Author(s): R. Douglas Collins
  • Year of Publication: 2007
  • Copyright Details: Differential Diagnosis in Primary Care, Copyright © 2007 Lippincott Williams & Wilkins.

Other Book Chapters Related to Calf pain

Read excerpts from these other book chapters related to Calf pain:

Medical Books Excerpts
  • BACK PAIN
  • "Algorithmic Diagnosis of Symptoms and Signs" (2003)
  • [ read ]
  • BREAST PAIN
  • "Algorithmic Diagnosis of Symptoms and Signs" (2003)
  • [ read ]
  • CHEST PAIN
  • "Algorithmic Diagnosis of Symptoms and Signs" (2003)
  • [ read ]
  • EYE PAIN
  • "Algorithmic Diagnosis of Symptoms and Signs" (2003)
  • [ read ]
  • FACE PAIN
  • "Algorithmic Diagnosis of Symptoms and Signs" (2003)
  • [ read ]
  • FLANK PAIN
  • "Algorithmic Diagnosis of Symptoms and Signs" (2003)
  • [ read ]
  • GIRDLE PAIN
  • "Algorithmic Diagnosis of Symptoms and Signs" (2003)
  • [ read ]
  • HEEL PAIN
  • "Algorithmic Diagnosis of Symptoms and Signs" (2003)
  • [ read ]
  • HIP PAIN
  • "Algorithmic Diagnosis of Symptoms and Signs" (2003)
  • [ read ]
  • JAW PAIN
  • "Algorithmic Diagnosis of Symptoms and Signs" (2003)
  • [ read ]
  • Back Pain
  • "In A Page: Pediatric Signs and Symptoms" (2007)
  • [ read ]
  • Chest Pain
  • "In A Page: Pediatric Signs and Symptoms" (2007)
  • [ read ]
  • Hip Pain
  • "In A Page: Pediatric Signs and Symptoms" (2007)
  • [ read ]
  • Knee Pain
  • "In A Page: Pediatric Signs and Symptoms" (2007)
  • [ read ]
  • LEG PAIN
  • "Differential Diagnosis in Primary Care" (2007)
  • [ read ]
  • ARM PAIN
  • "Differential Diagnosis in Primary Care" (2007)
  • [ read ]
  • EYE PAIN
  • "Differential Diagnosis in Primary Care" (2007)
  • [ read ]
  • HIP PAIN
  • "Differential Diagnosis in Primary Care" (2007)
  • [ read ]
  • Leg pain
  • "Handbook of Signs & Symptoms (Third Edition)" (2006)
  • [ read ]
  • Arm pain
  • "Handbook of Signs & Symptoms (Third Edition)" (2006)
  • [ read ]
  • Back pain
  • "Handbook of Signs & Symptoms (Third Edition)" (2006)
  • [ read ]
  • Chest pain
  • "Handbook of Signs & Symptoms (Third Edition)" (2006)
  • [ read ]
  • Eye pain
  • "Handbook of Signs & Symptoms (Third Edition)" (2006)
  • [ read ]
  • Flank pain
  • "Handbook of Signs & Symptoms (Third Edition)" (2006)
  • [ read ]
  • Jaw pain
  • "Handbook of Signs & Symptoms (Third Edition)" (2006)
  • [ read ]
  • Neck pain
  • "Handbook of Signs & Symptoms (Third Edition)" (2006)
  • [ read ]
  • Rectal pain
  • "Handbook of Signs & Symptoms (Third Edition)" (2006)
  • [ read ]
  • Throat pain
  • "Handbook of Signs & Symptoms (Third Edition)" (2006)
  • [ read ]
  • Back Pain
  • "A Pocket Manual of Differential Diagnosis" (1999)
  • [ read ]
  • Chest Pain
  • "A Pocket Manual of Differential Diagnosis" (1999)
  • [ read ]
  • Homans' sign
  • "Professional Guide to Signs & Symptoms (Fifth Edition)" (2006)
  • [ read ]
  • Leg Pain
  • "Professional Guide to Signs & Symptoms (Fifth Edition)" (2006)
  • [ read ]
  • Arm pain
  • "Professional Guide to Signs & Symptoms (Fifth Edition)" (2006)
  • [ read ]
  • Back pain
  • "Professional Guide to Signs & Symptoms (Fifth Edition)" (2006)
  • [ read ]
  • Chest pain
  • "Professional Guide to Signs & Symptoms (Fifth Edition)" (2006)
  • [ read ]
  • Facial pain
  • "Professional Guide to Signs & Symptoms (Fifth Edition)" (2006)
  • [ read ]
  • Flank pain
  • "Professional Guide to Signs & Symptoms (Fifth Edition)" (2006)
  • [ read ]
  • Jaw pain
  • "Professional Guide to Signs & Symptoms (Fifth Edition)" (2006)
  • [ read ]
  • Neck pain
  • "Professional Guide to Signs & Symptoms (Fifth Edition)" (2006)
  • [ read ]
  • Rectal pain
  • "Professional Guide to Signs & Symptoms (Fifth Edition)" (2006)
  • [ read ]
  • Throat pain
  • "Professional Guide to Signs & Symptoms (Fifth Edition)" (2006)
  • [ read ]
  • Calf Pain
  • "The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter" (2000)
  • [ read ]
  • Chest Pain, Atypical
  • "The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter" (2000)
  • [ read ]
  • Low Back Pain
  • "The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter" (2000)
  • [ read ]
  • Abdominal Pain
  • "The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter" (2000)
  • [ read ]
  • Chronic Pelvic Pain
  • "The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter" (2000)
  • [ read ]
  • Hip Pain
  • "The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter" (2000)
  • [ read ]
  • Knee Pain
  • "The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter" (2000)
  • [ read ]
  • Neck Pain
  • "The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter" (2000)
  • [ read ]
  • Pleuritic Pain
  • "The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter" (2000)
  • [ read ]
  • Scrotal Pain
  • "The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter" (2000)
  • [ read ]
  • Shoulder Pain
  • "The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter" (2000)
  • [ read ]
  • Eye Pain
  • "Field Guide to Bedside Diagnosis" (2007)
  • [ read ]
  • Hip Pain
  • "Field Guide to Bedside Diagnosis" (2007)
  • [ read ]
  • Homans' sign
  • "Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series" (2007)
  • [ read ]
  • Abdominal pain
  • "Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series" (2007)
  • [ read ]
  • Back pain
  • "Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series" (2007)
  • [ read ]
  • Chest pain
  • "Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series" (2007)
  • [ read ]
  • Eye pain
  • "Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series" (2007)
  • [ read ]
  • Flank pain
  • "Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series" (2007)
  • [ read ]
  • Jaw pain
  • "Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series" (2007)
  • [ read ]
  • Neck pain
  • "Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series" (2007)
  • [ read ]
  • Homans' sign
  • "Signs & Symptoms: A 2-in-1 Reference for Nurses" (2007)
  • [ read ]
  • Leg pain
  • "Signs & Symptoms: A 2-in-1 Reference for Nurses" (2007)
  • [ read ]
  • Arm pain
  • "Signs & Symptoms: A 2-in-1 Reference for Nurses" (2007)
  • [ read ]
  • Back pain
  • "Signs & Symptoms: A 2-in-1 Reference for Nurses" (2007)
  • [ read ]
  • Breast pain
  • "Signs & Symptoms: A 2-in-1 Reference for Nurses" (2007)
  • [ read ]
  • Chest pain
  • "Signs & Symptoms: A 2-in-1 Reference for Nurses" (2007)
  • [ read ]
  • Eye pain
  • "Signs & Symptoms: A 2-in-1 Reference for Nurses" (2007)
  • [ read ]
  • Facial pain
  • "Signs & Symptoms: A 2-in-1 Reference for Nurses" (2007)
  • [ read ]
  • Flank pain
  • "Signs & Symptoms: A 2-in-1 Reference for Nurses" (2007)
  • [ read ]
  • Jaw pain
  • "Signs & Symptoms: A 2-in-1 Reference for Nurses" (2007)
  • [ read ]
  • Neck pain
  • "Signs & Symptoms: A 2-in-1 Reference for Nurses" (2007)
  • [ read ]
  • Rectal pain
  • "Signs & Symptoms: A 2-in-1 Reference for Nurses" (2007)
  • [ read ]
  • Throat pain
  • "Signs & Symptoms: A 2-in-1 Reference for Nurses" (2007)
  • [ read ]
  • Abdominal Pain
  • "The Diagnostic Approach to Symptoms and Signs in Pediatrics" (2006)
  • [ read ]
  • Back Pain
  • "The Diagnostic Approach to Symptoms and Signs in Pediatrics" (2006)
  • [ read ]
  • Chest Pain
  • "The Diagnostic Approach to Symptoms and Signs in Pediatrics" (2006)
  • [ read ]
  • Leg pain
  • "Nursing: Interpreting Signs and Symptoms" (2007)
  • [ read ]
  • Arm pain
  • "Nursing: Interpreting Signs and Symptoms" (2007)
  • [ read ]
  • Back pain
  • "Nursing: Interpreting Signs and Symptoms" (2007)
  • [ read ]
  • Chest pain
  • "Nursing: Interpreting Signs and Symptoms" (2007)
  • [ read ]
  • Flank pain
  • "Nursing: Interpreting Signs and Symptoms" (2007)
  • [ read ]
  • Jaw pain
  • "Nursing: Interpreting Signs and Symptoms" (2007)
  • [ read ]
  • Neck pain
  • "Nursing: Interpreting Signs and Symptoms" (2007)
  • [ read ]
  • LEG PAIN
  • "Differential Diagnosis in Primary Care" (2007)
  • [ read ]
  • ARM PAIN
  • "Differential Diagnosis in Primary Care" (2007)
  • [ read ]
  • EYE PAIN
  • "Differential Diagnosis in Primary Care" (2007)
  • [ read ]
  • HIP PAIN
  • "Differential Diagnosis in Primary Care" (2007)
  • [ read ]
 

Copyright Details: Differential Diagnosis in Primary Care, Copyright © 2008 Williams & Wilkins.

More About Causes of Calf pain



More About This Book:
Title: Differential Diagnosis in Primary Care
Authors: R. Douglas Collins
Publisher: Lippincott Williams & Wilkins
Copyright: 2007
ISBN: 0-7817-6812-8

 » Next page: GROIN PAIN (Differential Diagnosis in Primary Care)

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