Kidney stone differential diagnosis: Difference between revisions

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__NOTOC__
__NOTOC__
{{Kidney stone}}
[[Image:Home_logo1.png|right|250px|link=https://www.wikidoc.org/index.php/Kidney_stone]]
{{CMG}}; {{AE}}  
{{CMG}}; {{AE}} {{HK}} {{ADS}}  


==Overview==
==Overview==
[Disease name] must be differentiated from other diseases that cause [clinical feature 1], [clinical feature 2], and [clinical feature 3], such as [differential dx1], [differential dx2], and [differential dx3].
Nephrolithiasis should be differentiated from other conditions presenting with [[Flank Pain|acute flank]] or [[upper abdominal pain]], [[hematuria]], [[nausea and vomiting]].
 
OR
 
[Disease name] must be differentiated from [[differential dx1], [differential dx2], and [differential dx3].


==Differentiating Nephrolithiasis from other Diseases==
==Differentiating Nephrolithiasis from other Diseases==
Nephrolithiasis should be differentiated from other conditions presenting with acute flank or upper abdominal pain, hematuria, nausea and vomiting. The differentials include the following:
Nephrolithiasis should be differentiated from other conditions presenting with [[Flank pain|acute flank]] or [[upper abdominal pain]], [[hematuria]], [[nausea and vomiting]]. The differentials include the following:<ref name="pmid18486720">{{cite journal |vauthors=Worcester EM, Coe FL |title=Nephrolithiasis |journal=Prim. Care |volume=35 |issue=2 |pages=369–91, vii |date=June 2008 |pmid=18486720 |pmc=2518455 |doi=10.1016/j.pop.2008.01.005 |url=}}</ref><ref name="pmid21789078">{{cite journal |vauthors=Semins MJ, Matlaga BR |title=Medical evaluation and management of urolithiasis |journal=Ther Adv Urol |volume=2 |issue=1 |pages=3–9 |date=February 2010 |pmid=21789078 |pmc=3126068 |doi=10.1177/1756287210369121 |url=}}</ref><ref name="pmid28764263">{{cite journal |vauthors=Venkatesh L, Hanumegowda RK |title=Acute Pyelonephritis - Correlation of Clinical Parameter with Radiological Imaging Abnormalities |journal=J Clin Diagn Res |volume=11 |issue=6 |pages=TC15–TC18 |date=June 2017 |pmid=28764263 |pmc=5535453 |doi=10.7860/JCDR/2017/27247.10033 |url=}}</ref><ref name="pmid17375337">{{cite journal |vauthors=Garin EH, Olavarria F, Araya C, Broussain M, Barrera C, Young L |title=Diagnostic significance of clinical and laboratory findings to localize site of urinary infection |journal=Pediatr. Nephrol. |volume=22 |issue=7 |pages=1002–6 |date=July 2007 |pmid=17375337 |doi=10.1007/s00467-007-0465-7 |url=}}</ref><ref name="pmid19399273">{{cite journal |vauthors=Lee DG, Jeon SH, Lee CH, Lee SJ, Kim JI, Chang SG |title=Acute pyelonephritis: clinical characteristics and the role of the surgical treatment |journal=J. Korean Med. Sci. |volume=24 |issue=2 |pages=296–301 |date=April 2009 |pmid=19399273 |pmc=2672131 |doi=10.3346/jkms.2009.24.2.296 |url=}}</ref><ref name="pmid22969301">{{cite journal |vauthors=Saeed K |title=Renal infarction |journal=Int J Nephrol Renovasc Dis |volume=5 |issue= |pages=119–23 |date=2012 |pmid=22969301 |pmc=3437809 |doi=10.2147/IJNRD.S33768 |url=}}</ref><ref name="pmid24812524">{{cite journal |vauthors=Mahamid M, Francis A, Abid A, Awawde M, Abu-Elhija O |title=Embolic renal infarction mimicking renal colic |journal=Int J Nephrol Renovasc Dis |volume=7 |issue= |pages=157–9 |date=2014 |pmid=24812524 |pmc=4011809 |doi=10.2147/IJNRD.S59745 |url=}}</ref><ref name="pmid12389340">{{cite journal |vauthors=Korzets Z, Plotkin E, Bernheim J, Zissin R |title=The clinical spectrum of acute renal infarction |journal=Isr. Med. Assoc. J. |volume=4 |issue=10 |pages=781–4 |date=October 2002 |pmid=12389340 |doi= |url=}}</ref><ref name="pmid12512867">{{cite journal |vauthors=Brix AE |title=Renal papillary necrosis |journal=Toxicol Pathol |volume=30 |issue=6 |pages=672–4 |date=2002 |pmid=12512867 |doi=10.1080/01926230290166760 |url=}}</ref><ref name="pmid7038374">{{cite journal |vauthors=Eknoyan G, Qunibi WY, Grissom RT, Tuma SN, Ayus JC |title=Renal papillary necrosis: an update |journal=Medicine (Baltimore) |volume=61 |issue=2 |pages=55–73 |date=March 1982 |pmid=7038374 |doi= |url=}}</ref><ref name="pmid18806169">{{cite journal |vauthors=Ng CS, Wood CG, Silverman PM, Tannir NM, Tamboli P, Sandler CM |title=Renal cell carcinoma: diagnosis, staging, and surveillance |journal=AJR Am J Roentgenol |volume=191 |issue=4 |pages=1220–32 |date=October 2008 |pmid=18806169 |doi=10.2214/AJR.07.3568 |url=}}</ref><ref name="pmid15536955">{{cite journal |vauthors=Ares Valdés Y, Amador Sandoval B, Morales JC, Alonso Domínguez F, Carballo Velásquez L, Fragas Valdés R, Shou Rodríguez A |title=[The role of CT scan in the diagnosis of renal cell carcinoma] |language=Spanish; Castilian |journal=Arch. Esp. Urol. |volume=57 |issue=7 |pages=737–42 |date=September 2004 |pmid=15536955 |doi= |url=}}</ref><ref name="pmid20479778">{{cite journal |vauthors=Leveridge MJ, Bostrom PJ, Koulouris G, Finelli A, Lawrentschuk N |title=Imaging renal cell carcinoma with ultrasonography, CT and MRI |journal=Nat Rev Urol |volume=7 |issue=6 |pages=311–25 |date=June 2010 |pmid=20479778 |doi=10.1038/nrurol.2010.63 |url=}}</ref><ref name="pmid23596502">{{cite journal |vauthors=Tritschler S, Roosen A, Füllhase C, Stief CG, Rübben H |title=Urethral stricture: etiology, investigation and treatments |journal=Dtsch Arztebl Int |volume=110 |issue=13 |pages=220–6 |date=March 2013 |pmid=23596502 |pmc=3627163 |doi=10.3238/arztebl.2013.0220 |url=}}</ref><ref name="pmid21176068">{{cite journal |vauthors=Mundy AR, Andrich DE |title=Urethral strictures |journal=BJU Int. |volume=107 |issue=1 |pages=6–26 |date=January 2011 |pmid=21176068 |doi=10.1111/j.1464-410X.2010.09800.x |url=}}</ref><ref name="pmid26816803">{{cite journal |vauthors=Maciejewski C, Rourke K |title=Imaging of urethral stricture disease |journal=Transl Androl Urol |volume=4 |issue=1 |pages=2–9 |date=February 2015 |pmid=26816803 |pmc=4708283 |doi=10.3978/j.issn.2223-4683.2015.02.03 |url=}}</ref><ref name="pmid20664404">{{cite journal |vauthors=Soper DE |title=Pelvic inflammatory disease |journal=Obstet Gynecol |volume=116 |issue=2 Pt 1 |pages=419–28 |date=August 2010 |pmid=20664404 |doi=10.1097/AOG.0b013e3181e92c54 |url=}}</ref><ref name="pmid9891675">{{cite journal |vauthors=Paavonen J |title=Pelvic inflammatory disease. From diagnosis to prevention |journal=Dermatol Clin |volume=16 |issue=4 |pages=747–56, xii |date=October 1998 |pmid=9891675 |doi= |url=}}</ref><ref name="pmid24802548">{{cite journal |vauthors=Lee MH, Moon MH, Sung CK, Woo H, Oh S |title=CT findings of acute pelvic inflammatory disease |journal=Abdom Imaging |volume=39 |issue=6 |pages=1350–5 |date=December 2014 |pmid=24802548 |doi=10.1007/s00261-014-0158-1 |url=}}</ref><ref name="pmid17054801">{{cite journal |vauthors=Eggert J, Sundquist K, van Vuuren C, Fianu-Jonasson A |title=The clinical diagnosis of pelvic inflammatory disease--reuse of electronic medical record data from 189 patients visiting a Swedish university hospital emergency department |journal=BMC Womens Health |volume=6 |issue= |pages=16 |date=October 2006 |pmid=17054801 |pmc=1624808 |doi=10.1186/1472-6874-6-16 |url=}}</ref><ref name="pmid24294125">{{cite journal |vauthors=Washington C, Carmichael JC |title=Management of ischemic colitis |journal=Clin Colon Rectal Surg |volume=25 |issue=4 |pages=228–35 |date=December 2012 |pmid=24294125 |pmc=3577613 |doi=10.1055/s-0032-1329534 |url=}}</ref><ref name="pmid25941431">{{cite journal |vauthors=Chawla YK, Bodh V |title=Portal vein thrombosis |journal=J Clin Exp Hepatol |volume=5 |issue=1 |pages=22–40 |date=March 2015 |pmid=25941431 |pmc=4415192 |doi=10.1016/j.jceh.2014.12.008 |url=}}</ref><ref name="urlImaging of Abdominal Aortic Aneurysms - - American Family Physician">{{cite web |url=https://www.aafp.org/afp/2002/0415/p1565.html |title=Imaging of Abdominal Aortic Aneurysms - - American Family Physician |format= |work= |accessdate=}}</ref><ref name="pmid21523201">{{cite journal |vauthors=Aggarwal S, Qamar A, Sharma V, Sharma A |title=Abdominal aortic aneurysm: A comprehensive review |journal=Exp Clin Cardiol |volume=16 |issue=1 |pages=11–5 |date=2011 |pmid=21523201 |pmc=3076160 |doi= |url=}}</ref><ref name="pmid20676257">{{cite journal |vauthors=Destigter KK, Keating DP |title=Imaging update: acute colonic diverticulitis |journal=Clin Colon Rectal Surg |volume=22 |issue=3 |pages=147–55 |date=August 2009 |pmid=20676257 |pmc=2780264 |doi=10.1055/s-0029-1236158 |url=}}</ref><ref name="pmid24888393">{{cite journal |vauthors=Hameed AM, Lam VW, Pleass HC |title=Significant elevations of serum lipase not caused by pancreatitis: a systematic review |journal=HPB (Oxford) |volume=17 |issue=2 |pages=99–112 |date=February 2015 |pmid=24888393 |pmc=4299384 |doi=10.1111/hpb.12277 |url=}}</ref><ref name="urlImaging for Suspected Appendicitis - - American Family Physician">{{cite web |url=https://www.aafp.org/afp/2005/0101/p71.html |title=Imaging for Suspected Appendicitis - - American Family Physician |format= |work= |accessdate=}}</ref><ref name="urlCT Findings of Acute Cholecystitis and Its Complications : American Journal of Roentgenology : Vol. 194, No. 6 (AJR)">{{cite web |url=https://www.ajronline.org/doi/full/10.2214/AJR.09.3640 |title=CT Findings of Acute Cholecystitis and Its Complications : American Journal of Roentgenology : Vol. 194, No. 6 (AJR) |format= |work= |accessdate=}}</ref><ref name="urlEpididymitis and Orchitis: An Overview - - American Family Physician">{{cite web |url=https://www.aafp.org/afp/2009/0401/p583.html |title=Epididymitis and Orchitis: An Overview - - American Family Physician |format= |work= |accessdate=}}</ref><ref name="pmid26526901">{{cite journal |vauthors=Jia JB, Houshyar R, Verma S, Uchio E, Lall C |title=Prostate cancer on computed tomography: A direct comparison with multi-parametric magnetic resonance imaging and tissue pathology |journal=Eur J Radiol |volume=85 |issue=1 |pages=261–267 |date=January 2016 |pmid=26526901 |doi=10.1016/j.ejrad.2015.10.013 |url=}}</ref><ref name="pmid25393274">{{cite journal |vauthors=Bratt O, Lilja H |title=Serum markers in prostate cancer detection |journal=Curr Opin Urol |volume=25 |issue=1 |pages=59–64 |date=January 2015 |pmid=25393274 |pmc=4315142 |doi=10.1097/MOU.0000000000000128 |url=}}</ref><ref name="urlProstate Cancer (Prostate Carcinoma): Symptoms - National Library of Medicine - PubMed Health">{{cite web |url=https://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0024422/ |title=Prostate Cancer (Prostate Carcinoma): Symptoms - National Library of Medicine - PubMed Health |format= |work= |accessdate=}}</ref><ref name="pmid25675798">{{cite journal |vauthors=Eskicioğlu F, Özdemir AT, Turan GA, Gür EB, Kasap E, Genç M |title=The efficacy of complete blood count parameters in the diagnosis of tubal ectopic pregnancy |journal=Ginekol. 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{|
{| class="wikitable"
! rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" + |Category
! rowspan="2" |Category
! rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" + |Disease
! rowspan="2" |Disease
! rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" + |Risk factors
! rowspan="2" |History
! colspan="5" align="center" style="background:#4479BA; color: #FFFFFF;" + |Symptoms
! colspan="11" |Signs and Symptoms
! colspan="6" align="center" style="background:#4479BA; color: #FFFFFF;" + |Signs
! colspan="3" |Physical Examination
! colspan="8" align="center" style="background:#4479BA; color: #FFFFFF;" + |Paraclinical studies
! colspan="10" |Laboratory abnormalities
|-
|-
|'''Nausea/vomiting'''
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Pain
|'''Hematuria'''
! align="center" style="background:#4479BA; color: #FFFFFF;" + |N/V
|'''Location of pain'''
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Anorexia
|'''Fever'''
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Constipation
|'''Tachycardia'''
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Urinary symptoms
|'''Hypotension'''
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Fever
|'''Hypertension'''
! align="center" style="background:#4479BA; color: #FFFFFF;" + |HR
|'''Anorexia'''
! align="center" style="background:#4479BA; color: #FFFFFF;" + |BP
|'''Constipation'''
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Tenderness
|'''Rebound abdominal tenderness'''
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Abdominopelvic exam
|'''Urinary frequency/Urgency/Dysuria'''
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Rectal exam
|'''Costovetebral angle tenderness'''
! align="center" style="background:#4479BA; color: #FFFFFF;" + |CBC
|'''Pelvic Examination'''
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Urinalysis
|'''Rectal Examination'''
! align="center" style="background:#4479BA; color: #FFFFFF;" + |BUN
|'''Complete Blood Count (CBC)'''
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Cr
|'''Urinalysis'''
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Urine Beta−hCG
|'''BUN'''
! align="center" style="background:#4479BA; color: #FFFFFF;" + |LFT
|'''Creatinine'''
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Serum amylase & lipase
|'''Stone analysis'''
! align="center" style="background:#4479BA; color: #FFFFFF;" + |CT
|'''Urine Beta- hCG'''
|'''Abnormal Liver Function Tests (LFTs)'''
|'''Serum Amylase/Lipase'''
|'''Abdominal/Pelvic CT scan'''
|'''Serum Parathyroid hormone levels (PTH)'''
|-
|-
| rowspan="6" |Renal Pathology
! rowspan="6" align="center" style="background:#4479BA; color: #FFFFFF;" + |Renal Pathology
|Nephrolithiasis
! align="center" style="background:#DCDCDC;" + |Nephrolithiasis
|
| align="left" style="background:#F5F5F5;" + |
* Primary hyper parathyroidism
* Inadequate dietary [[calcium]] intake
* Inadequate dietary calcium intake
* [[Renal tubular acidosis]]
* Hypercalciuria
* Infection
* Hyperoxaluria
| align="left" style="background:#F5F5F5;" + |
* Cystinuria
* [[Flank Pain|Flank]]/[[back pain]] radiating to groin
* Renal tubular acidosis
| align="center" style="background:#F5F5F5;" + |<nowiki>+</nowiki>
* Infection with urease producing bacteria (''Ureaplasma urealyticum'', ''Klebsiella'', ''Protues'')
| align="center" style="background:#F5F5F5;" + |±
|<nowiki>+</nowiki>
| align="center" style="background:#F5F5F5;" + |−
|<nowiki>+</nowiki>
| align="center" style="background:#F5F5F5;" + |<nowiki>+</nowiki>
|
| align="center" style="background:#F5F5F5;" + | −
* Flank/back pain radiating to groin
| align="center" style="background:#F5F5F5;" + |↑
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |Nl
|<nowiki>+</nowiki>
| align="center" style="background:#F5F5F5;" + |−
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |Nl
| -
| align="center" style="background:#F5F5F5;" + |Nl
|<nowiki>+/-</nowiki>
| align="center" style="background:#F5F5F5;" + |Nl
|<nowiki>-</nowiki>
| align="left" style="background:#F5F5F5;" + |
|<nowiki>-</nowiki>
* [[Hematuria]]
|<nowiki>+</nowiki>
* [[Hypercalciuria]]
|<nowiki>-</nowiki>
* [[Hyperoxaluria]]
|<nowiki>-</nowiki>
* [[Cystinuria]]
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |Nl
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |Nl
|
| align="center" style="background:#F5F5F5;" + |−
|
| align="center" style="background:#F5F5F5;" + |Nl
|
| align="center" style="background:#F5F5F5;" + |Nl
|
| align="left" style="background:#F5F5F5;" + |
|<nowiki>-</nowiki>
* Radiolucent stone
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|
* Non-contrast CT scan may show stone as radiolucency
|<nowiki>+/-</nowiki>
|-
|-
|Pyelonephritis
! align="center" style="background:#DCDCDC;" + |[[Pyelonephritis]]
|
| align="left" style="background:#F5F5F5;" + |
* Urinary tract infection
* [[Urinary tract obstruction]]
* Immunocompromised state (Diabetes, immunosuppressive medications)
* [[Pregnancy]]
* Urinary tract obstruction
* Urinary instrumentation
* History of pyelonephritis
| align="left" style="background:#F5F5F5;" + |
* Pregnancy
* [[Costovertebral angle]]
* Presence of urinary catheter, stent, nephrostomy tube
| align="center" style="background:#F5F5F5;" + |<nowiki>+</nowiki>
|<nowiki>+</nowiki>
| align="center" style="background:#F5F5F5;" + |±
|<nowiki>+ (microscopic)</nowiki>
| align="center" style="background:#F5F5F5;" + |−
|
| align="center" style="background:#F5F5F5;" + |<nowiki>+</nowiki>
* Costovertebral angle
| align="center" style="background:#F5F5F5;" + |<nowiki>+</nowiki>
| align="center" style="background:#F5F5F5;" + |↑
| align="center" style="background:#F5F5F5;" + |↓
| align="left" style="background:#F5F5F5;" + |
* Positive renal punch sign
* Positive renal punch sign
|<nowiki>+</nowiki>
* Costovertebral angle [[tenderness]]
|<nowiki>+</nowiki>
| align="left" style="background:#F5F5F5;" + |
|<nowiki>+</nowiki>
* [[Urethritis]]
| -
* [[Vaginitis]]
|<nowiki>+/-</nowiki>
| align="center" style="background:#F5F5F5;" + |Nl
|<nowiki>-</nowiki>
| align="left" style="background:#F5F5F5;" + |
|<nowiki>+</nowiki>
* [[Leukocytosis]]
|<nowiki>+</nowiki>
| align="left" style="background:#F5F5F5;" + |
|<nowiki>+</nowiki>
* [[Hematuria|Microscopic hematuria]]
|
* [[Pyuria]]
* Uretheritis
* Positive [[leukocyte esterase]]
* Vaginitis
| align="center" style="background:#F5F5F5;" + |Nl
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |Nl
|
| align="center" style="background:#F5F5F5;" + |Might be +
* Leukocytosis
| align="center" style="background:#F5F5F5;" + |Nl
|
| align="center" style="background:#F5F5F5;" + |Nl
* Pyuria
| align="left" style="background:#F5F5F5;" + |
* Positive leukocyte esterase
* Decreased contrast uptake
|
* Foci from [[abscess]] pockets
|
|<nowiki>-</nowiki>
| -
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|
* Globaly decreased contrast uptake
*  Foci from abscess pockets
|<nowiki>-</nowiki>
|-
|-
|Renal infarct
! align="center" style="background:#DCDCDC;" + |[[Renal infarct]]
|
| align="left" style="background:#F5F5F5;" + |
* Sickle cell disease or trait
* [[Sickle-cell disease|Sickle cell disease]] or trait
* Thrombosis
* [[Trauma]]
* Trauma
| align="left" style="background:#F5F5F5;" + |
* Hypertension
* [[Flank pain]]
* Cardiac arrhythmia
| align="center" style="background:#F5F5F5;" + |<nowiki>+</nowiki>
* Coagulopathy
| align="center" style="background:#F5F5F5;" + |−
* Atherosclerosis
| align="center" style="background:#F5F5F5;" + |−
|<nowiki>+</nowiki>
| align="center" style="background:#F5F5F5;" + |−
|<nowiki>+</nowiki>
| align="center" style="background:#F5F5F5;" + |<nowiki>+</nowiki>
|
| align="center" style="background:#F5F5F5;" + |↑
* Flank pain
| align="center" style="background:#F5F5F5;" + |↑
|<nowiki>+</nowiki>
| align="center" style="background:#F5F5F5;" + |−
|<nowiki>+</nowiki>
| align="center" style="background:#F5F5F5;" + |Nl
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |Nl
| +
| align="left" style="background:#F5F5F5;" + |
|<nowiki>-</nowiki>
* [[Leukocytosis]]
|<nowiki>-</nowiki>
| align="left" style="background:#F5F5F5;" + |
|<nowiki>-</nowiki>
* [[Hematuria]]
|<nowiki>-</nowiki>
* [[Proteinuria]]
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |Nl to ↑
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |Nl
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |−
|
| align="center" style="background:#F5F5F5;" + |Nl
* Leukocytosis
| align="center" style="background:#F5F5F5;" + |Nl
|
| align="left" style="background:#F5F5F5;" + |
* Red blood cells
* Decreased contrast uptake
* Proteinuria
|
|
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|
|
|
|<nowiki>-</nowiki>
|-
|-
|Renal papillary necrosis
! align="center" style="background:#DCDCDC;" + |[[Renal papillary necrosis]]
|
| align="left" style="background:#F5F5F5;" + |
* Analgesic use (Phenacetin, acetaminophen, NSAIDs)
* [[Analgesic]] use
* Pyelonephritis
* [[Sickle cell disease]]
* Urinary tract obstruction
* [[Tuberculosis]]
* Sickle cell disease
* [[Cirrhosis]]
* Tuberculosis
* [[Diabetes]]
* Cirrhosis
* [[Vasculitis]]
* Diabetes
* [[Renal vein thrombosis]]
* Vasculitis
| align="left" style="background:#F5F5F5;" + |
* Renal vein thrombosis
* [[Flank pain]]
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |−
|<nowiki>+ (microscopic)</nowiki>
| align="center" style="background:#F5F5F5;" + |−
|
| align="center" style="background:#F5F5F5;" + |−
* Flank pain
| align="center" style="background:#F5F5F5;" + |<nowiki>+</nowiki>
|<nowiki>+</nowiki>
| align="center" style="background:#F5F5F5;" + |<nowiki>+</nowiki>
|<nowiki>+/-</nowiki>
| align="center" style="background:#F5F5F5;" + |±
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |↑
| +
| align="center" style="background:#F5F5F5;" + |−
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |Nl
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |Nl
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |Nl
|<nowiki>+</nowiki>
| align="left" style="background:#F5F5F5;" + |
|<nowiki>-</nowiki>
* [[Bacteriuria]]
|<nowiki>-</nowiki>
* [[Pyuria]]
|<nowiki>-</nowiki>
* [[Microscopic hematuria]]
|
| align="center" style="background:#F5F5F5;" + |Nl to ↑
|
| align="center" style="background:#F5F5F5;" + |Nl
* Bacteriuria
| align="center" style="background:#F5F5F5;" + |−
* Pyuria
| align="center" style="background:#F5F5F5;" + |Nl
* Microscopic hematuria
| align="center" style="background:#F5F5F5;" + |Nl
|
| align="left" style="background:#F5F5F5;" + |
|
* Blunted [[renal calyces]]
|<nowiki>-</nowiki>
* Non−enhanced lesions surrounded by rings of excreted contrast material
|<nowiki>-</nowiki>
* Hyperattenuated [[medullary]] [[Calcification|calcifications]]
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|
* Blunted renal calyces
* Contrast material–filled clefts in the renal medulla
* Non-enhanced lesions surrounded by rings of excreted contrast material
* Hyperattenuated medullary calcifications
|<nowiki>-</nowiki>
|-
|-
|Renal cell carcinoma
! align="center" style="background:#DCDCDC;" + |[[Renal cell carcinoma]]
|
| align="left" style="background:#F5F5F5;" + |
* Weight loss
* History of [[smoking]]
* History of smoking
* [[Von Hippel-Lindau disease|Von−Hippel Lindau disease]]
* Obesity
| align="left" style="background:#F5F5F5;" + |
* Von-Hippel Lindau disease
* [[Flank pain]]
* Night sweats
| align="center" style="background:#F5F5F5;" + | +
* Malaise
| align="center" style="background:#F5F5F5;" + |<nowiki>+</nowiki>
| align="center" style="background:#F5F5F5;" + |±
| align="center" style="background:#F5F5F5;" + |−
| align="center" style="background:#F5F5F5;" + |−
| align="center" style="background:#F5F5F5;" + |−
| align="center" style="background:#F5F5F5;" + |↑
| align="center" style="background:#F5F5F5;" + |−
| align="left" style="background:#F5F5F5;" + |
* Flank mass
* Flank mass
| +
| align="center" style="background:#F5F5F5;" + |Nl
|<nowiki>+ (microscopic)</nowiki>
| align="left" style="background:#F5F5F5;" + |
|
* [[Anemia]]
* Flank pain
| align="left" style="background:#F5F5F5;" + |
|<nowiki>-</nowiki>
* [[Microscopic hematuria]]
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
| +
|<nowiki>+</nowiki>
|<nowiki>+/-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|
* Anemia
|
* Microscopic hemeturia
* Renal cell casts
* Renal cell casts
* Urinary aquaporin-1 (AQP1) and adipophilin (ADFP)- proximal renal tubular cancer
* Urinary [[Aquaporin 1|aquaporin−1]] (AQP1) and adipophilin (ADFP)
|
| align="center" style="background:#F5F5F5;" + |Nl
|
| align="center" style="background:#F5F5F5;" + |Nl
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |−
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |Nl
| -
| align="center" style="background:#F5F5F5;" + |Nl
|<nowiki>-</nowiki>
| align="left" style="background:#F5F5F5;" + |
|
* Soft tissue attenuation 
* Non-contrast CT:
* [[Calcification]] and [[necrosis]]
** Lesions are soft tissue attenuation 
* Homogenous to irregular contrast enhancement
** Areas of calcification and necrosis
|-
* Contrast-enhanced:
! align="center" style="background:#DCDCDC;" + |[[Urethral stricture]]
** Homogenous (small lesions) to irregular  (large lesions) contrast enhancement
| align="left" style="background:#F5F5F5;" + |
|<nowiki>-</nowiki>
* Prior [[urinary tract]] surgery
* [[Congenital]]
* [[Urinary catheterization]]
* Direct [[Penis|penile]] trauma
| align="center" style="background:#F5F5F5;" + |−
| align="center" style="background:#F5F5F5;" + |−
| align="center" style="background:#F5F5F5;" + |−
| align="center" style="background:#F5F5F5;" + |−
| align="center" style="background:#F5F5F5;" + |<nowiki>+</nowiki>
| align="center" style="background:#F5F5F5;" + |−
| align="center" style="background:#F5F5F5;" + |−
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |−
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |−
| align="left" style="background:#F5F5F5;" + |
* [[Hematuria]]
| align="center" style="background:#F5F5F5;" + |Nl to ↑
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |−
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |Nl
|-
|-
|Uretral stricture
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Category
|
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Disease
* Prior urinary tract surgery
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Risk factors
* Congenital
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Pain
* Urinary catheterization
! align="center" style="background:#4479BA; color: #FFFFFF;" + |N/V
* Direct penile trauma
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Anorexia
|<nowiki>-</nowiki>
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Constipation
|<nowiki>+/-</nowiki>
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Urinary symptoms
|<nowiki>-</nowiki>
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Fever
|<nowiki>-</nowiki>
! align="center" style="background:#4479BA; color: #FFFFFF;" + |HR
|<nowiki>-</nowiki>
! align="center" style="background:#4479BA; color: #FFFFFF;" + |BP
|<nowiki>-</nowiki>
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Tenderness
|<nowiki>-</nowiki>
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Abdominopelvic exam
|<nowiki>-</nowiki>
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Rectal exam
|<nowiki>-</nowiki>
! align="center" style="background:#4479BA; color: #FFFFFF;" + |CBC
|<nowiki>-</nowiki>
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Urinalysis
|<nowiki>+</nowiki>
! align="center" style="background:#4479BA; color: #FFFFFF;" + |BUN
|<nowiki>-</nowiki>
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Cr
|<nowiki>-</nowiki>
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Urine Beta−hCG
|<nowiki>-</nowiki>
! align="center" style="background:#4479BA; color: #FFFFFF;" + |LFT
|<nowiki>-</nowiki>
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Serum amylase & lipase
|<nowiki>-</nowiki>
! align="center" style="background:#4479BA; color: #FFFFFF;" + |CT
|
|
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|-
|-
| rowspan="3" |Gynecological Pathology
! rowspan="3" align="center" style="background:#4479BA; color: #FFFFFF;" + |Gynecological pathology
|Pelvic inflammatory disease
! align="center" style="background:#DCDCDC;" + |[[Pelvic inflammatory disease]]
|
| align="left" style="background:#F5F5F5;" + |
* Endometritis
* [[Caesarean section|Cesarean section]]
* Saplingitis
* Septic [[Pregnancy termination complications|abortion]]
* Cesarian section
* [[Tuberculosis]]
* Septic abortion
* [[Actinomycosis]]
* Urinary tract infection
| align="left" style="background:#F5F5F5;" + |
* Tuberculosis
* Actinomycosis
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|
* Right/left upper quadrant  
* Right/left upper quadrant  
|<nowiki>+</nowiki>
| align="center" style="background:#F5F5F5;" + |−
|<nowiki>+</nowiki>
| align="center" style="background:#F5F5F5;" + |<nowiki>+</nowiki>
|<nowiki>+</nowiki>
| align="center" style="background:#F5F5F5;" + |−
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |<nowiki>+</nowiki>
|<nowiki>+</nowiki>
| align="center" style="background:#F5F5F5;" + |<nowiki>+</nowiki>
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |<nowiki>+</nowiki>
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |↓
|<nowiki>+</nowiki>
| align="left" style="background:#F5F5F5;" + |
|<nowiki>-</nowiki>
* [[Cervical motion tenderness]]
|
* Cervical motion tenderness
* Adnexal tenderness
* Adnexal tenderness
* Foul smelling vaginal/urtetheral discharge
| align="left" style="background:#F5F5F5;" + |
|<nowiki>-</nowiki>
* [[Vaginal discharge|Foul smelling vaginal]]/[[Urethral discharge|urtetheral discharge]]
|
| align="center" style="background:#F5F5F5;" + |Nl
* Leukocytosis
| align="left" style="background:#F5F5F5;" + |
|
* [[Leukocytosis]]
* Bacteriuria (''Neisseria gonorrhoeae'' or ''Chlamydia trachomatis'', polymicrobial)
| align="left" style="background:#F5F5F5;" + |
* Pyuria
* [[Bacteriuria]] (''[[Neisseria]] [[Gonorrhoea|gonorrhoeae]]'' or ''[[Chlamydia trachomatis]]'', polymicrobial)
|
* [[Pyuria]]
|
| align="center" style="background:#F5F5F5;" + |Nl
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |Nl
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |Might be +
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |Nl
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |Nl
|
| align="left" style="background:#F5F5F5;" + |
* Thickening of the uterosacral ligaments
* Thickening of the [[uterosacral ligaments]]
* Haziness of the pelvic fat
* Periovarian stranding
* Periovarian stranding
* Enhancement of the adjacent peritoneum
* Enhancement of the adjacent [[peritoneum]]
* Thick-walled, complex fluid collection with septa formation (abscess pockets)
|<nowiki>-</nowiki>
|-
|-
|Ovarian torsion
! align="center" style="background:#DCDCDC;" + |[[Ovarian torsion]]
|
| align="center" style="background:#F5F5F5;" + |NA
* Sudden acute pain
| align="left" style="background:#F5F5F5;" + |
* Sharp pain aggravated by walking
* Acute unilateral poorly localized [[Lower abdominal pain|lower abdominal]] sharp colicky pain aggravated by walking
* Intermittent/colicky pain
| align="center" style="background:#F5F5F5;" + |<nowiki>+</nowiki>
|<nowiki>+</nowiki>
| align="center" style="background:#F5F5F5;" + |−
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |−
|
| align="center" style="background:#F5F5F5;" + |−
* Unilateral poorly localized lower abdominal
| align="center" style="background:#F5F5F5;" + |−
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |<nowiki>+</nowiki>
|<nowiki>+</nowiki>
| align="center" style="background:#F5F5F5;" + |Nl
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |−
|<nowiki>-</nowiki>
| align="left" style="background:#F5F5F5;" + |
|<nowiki>-</nowiki>
* [[Adnexal]] tenderness
|<nowiki>-</nowiki>
* [[Adnexal mass causes|Adnexal mass]]
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |Nl
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |−
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |−
|
| align="center" style="background:#F5F5F5;" + |−
* Adnexal tenderness
| align="center" style="background:#F5F5F5;" + |−
* Adnexal mass
| align="center" style="background:#F5F5F5;" + |−
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |Nl
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |Nl
|<nowiki>-</nowiki>
| align="left" style="background:#F5F5F5;" + |
|<nowiki>-</nowiki>
* Twisted and distended [[ovarian]] pedicle
|<nowiki>-</nowiki>
* Enlarged [[ovary]] (>4.0 cm)
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|
* Twisted ovarian pedicle
* Enlarged ovary (>4.0 cm)
* Distended pedicle
* Possible underlying ovarian lesion
|<nowiki>-</nowiki>
|-
|-
|Ectopic pregnancy
! align="center" style="background:#DCDCDC;" + |[[Ectopic pregnancy]]
|
| align="left" style="background:#F5F5F5;" + |
* History of previous ectopic pregnancy
* History of previous [[ectopic pregnancy]]
* Tubal surgery
* Tubal surgery
* Intrauterine device usage
* [[Intrauterine device]] usage
* History of pelvic surgery
* History of [[pelvic]] surgery
* History of pelvic inflammatory disease
* Increased [[maternal]] age
* Sub-fertility
* [[Cigarette smoking]]
* Sternous excercise
| align="left" style="background:#F5F5F5;" + |
* Increased maternal age
* [[Lower abdominal pain|Lower abdominal]]
* Cigarette smoking
* Unilateral [[Shoulder Pain|shoulder]] or [[neck pain]] (referred)
|<nowiki>+</nowiki>
| align="center" style="background:#F5F5F5;" + |<nowiki>+</nowiki>
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |<nowiki>+</nowiki>
|
| align="center" style="background:#F5F5F5;" + |−
* Lower abdominal  
| align="center" style="background:#F5F5F5;" + |<nowiki>+</nowiki>
* Unilateral shoulder or neck pain (referred)
| align="center" style="background:#F5F5F5;" + |−
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |<nowiki>+</nowiki>
|<nowiki>+</nowiki>
| align="center" style="background:#F5F5F5;" + |↓ (if ruptured)
|<nowiki>-</nowiki>
| align="left" style="background:#F5F5F5;" + |
|<nowiki>-</nowiki>
* Positive abdominal tenderness (if ruptured)
|<nowiki>+</nowiki>
| align="left" style="background:#F5F5F5;" + |
|<nowiki>-</nowiki>
* [[Vaginal bleeding]]
|<nowiki>+ (if ruptured)</nowiki>
| align="center" style="background:#F5F5F5;" + |Nl
|<nowiki>+</nowiki>
| align="left" style="background:#F5F5F5;" + |
|<nowiki>-</nowiki>
|
* Vaginal bleeding
|<nowiki>-</nowiki>
|
* Low platelet distribution width (decreased platelet activation)
* Low platelet distribution width (decreased platelet activation)
* Monocytosis
* [[Monocytosis]]
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |−
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |−
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |−
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |<nowiki>+</nowiki>
|<nowiki>+</nowiki>
| align="center" style="background:#F5F5F5;" + |Might be abnormal
|<nowiki>+/-</nowiki>
| align="center" style="background:#F5F5F5;" + |Nl
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |NA
|N/A
|<nowiki>-</nowiki>
|-
|-
| rowspan="2" |Prostate Pathology
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Category
|Prostatitis
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Disease
|
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Risk factors
* Bacterial infection by:
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Pain
** ''Ureaplasma urealyticum''
! align="center" style="background:#4479BA; color: #FFFFFF;" + |N/V
** ''Proteus''
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Anorexia
** ''Chlamydia''
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Constipation
** ''Gonorrhea''
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Urinary symptoms
** ''E.Coli''
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Fever
** ''Pseudomonas''
! align="center" style="background:#4479BA; color: #FFFFFF;" + |HR
** ''Mycoplasma''
! align="center" style="background:#4479BA; color: #FFFFFF;" + |BP
* Prior history of prostatitis
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Tenderness
* Urinary tract infection
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Abdominopelvic exam
* Urinary catheterization
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Rectal exam
|<nowiki>-</nowiki>
! align="center" style="background:#4479BA; color: #FFFFFF;" + |CBC
|<nowiki>+</nowiki>
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Urinalysis
|
! align="center" style="background:#4479BA; color: #FFFFFF;" + |BUN
* Perineal pain
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Cr
* Lower back pain
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Urine Beta−hCG
! align="center" style="background:#4479BA; color: #FFFFFF;" + |LFT
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Serum amylase & lipase
! align="center" style="background:#4479BA; color: #FFFFFF;" + |CT
|-
! rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" + |Prostate pathology
! align="center" style="background:#DCDCDC;" + |[[Prostatitis]]
| align="left" style="background:#F5F5F5;" + |
* Bacterial infection
* Prior history of [[prostatitis]]
* [[Urinary catheterization]]
| align="left" style="background:#F5F5F5;" + |
* [[Perineal]] pain
* [[Lower back pain]]
* Suprapubic pain
* Suprapubic pain
|<nowiki>+</nowiki>
| align="center" style="background:#F5F5F5;" + |−
|<nowiki>+</nowiki>
| align="center" style="background:#F5F5F5;" + |−
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |−
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |<nowiki>+</nowiki>
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |<nowiki>+</nowiki>
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |<nowiki>+</nowiki>
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |Nl
|<nowiki>+</nowiki>
| align="center" style="background:#F5F5F5;" + |−
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |Nl
|<nowiki>-</nowiki>
| align="left" style="background:#F5F5F5;" + |
|
* Enlarged [[prostate]]
* Enlarged prostate
* [[Rectal pain]]
* Rectal pain
| align="left" style="background:#F5F5F5;" + |
|
* [[Leukocytosis]]
* Leukocytosis
| align="left" style="background:#F5F5F5;" + |
|
* [[Bacteriuria]]
* Bacteriuria
* [[Pyuria]]
* Pyuria
* [[Microscopic hematuria]]
* Microscopic hematuria
| align="center" style="background:#F5F5F5;" + |−
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |−
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |−
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |Nl
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |Nl
|<nowiki>-</nowiki>
| align="left" style="background:#F5F5F5;" + |
|<nowiki>-</nowiki>
* Edema of the [[prostate gland]] with diffuse enlargement
|
|<nowiki>-</nowiki>
|-
|-
|Prostatic cancer
! align="center" style="background:#DCDCDC;" + |[[Prostatic cancer]]
|
| align="left" style="background:#F5F5F5;" + |
* Family history of prostate cancer (1st degree relatives)
* [[Family history]] of [[Prostate cancer|prostate cancer]]
* Germline mutation of HOXB13 (G84E variant)
* [[Germline mutation]] of [[HOXB13]]
* Black ethnicity
* Black ethnicity
* Age > 50 years
* Age > 50 years
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |−
|<nowiki>+</nowiki>
| align="center" style="background:#F5F5F5;" + |−
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |<nowiki>+</nowiki>
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |−
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |<nowiki>+</nowiki>
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |−
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |−
|<nowiki>+</nowiki>
| align="center" style="background:#F5F5F5;" + |Nl
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |−
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |Nl
|<nowiki>+</nowiki>
| align="left" style="background:#F5F5F5;" + |
|<nowiki>-</nowiki>
* Enlarged [[prostate]]
|<nowiki>-</nowiki>
|
* Enlarged prostate
* Firm and hard
* Firm and hard
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |Nl
|
| align="left" style="background:#F5F5F5;" + |
* Positive prostate specific antigen (PSA)
* [[Hematuria]]
* High levels of TMPRSS2:ERG and PCA3
* Positive [[prostate specific antigen]]
|
* High levels of [[TMPRSS2]]:ERG and [[PCA3]]
|
| align="center" style="background:#F5F5F5;" + |Nl
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |Nl
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |−
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |Nl
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |Nl
|
| align="left" style="background:#F5F5F5;" + |
* Focal areas of mass-like enhancement in the peripheral prostate
* Focal areas of mass−like enhancement in the peripheral [[prostate]]
* Calcifications
* [[Calcification|Calcifications]]
|<nowiki>-</nowiki>
|-
|-
| rowspan="2" |Testicular Pathology
! rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" + |Testicular pathology
|Testicular torsion
! align="center" style="background:#DCDCDC;" + |[[Testicular torsion]]
|
| align="left" style="background:#F5F5F5;" + |
* Age 12 - 16 years
* Age 12 − 16 years
* Previous history of testicular torsion
* [[Family history]] of [[testicular torsion]]
* Family history of testicular torsion
* [[Prematurity]]
* Prematurity
* [[Undescended testes]]
* Undescended testes
| align="left" style="background:#F5F5F5;" + |
* Low birth weight
* Sudden onset unilateral [[testicular pain]]
|<nowiki>+</nowiki>
| align="center" style="background:#F5F5F5;" + |<nowiki>+</nowiki>
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |±
|
| align="center" style="background:#F5F5F5;" + |−
* Sudden onset unilateral testicular pain
| align="center" style="background:#F5F5F5;" + |±
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |−
|<nowiki>+</nowiki>
| align="center" style="background:#F5F5F5;" + |<nowiki>+</nowiki>
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |Nl
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |−
|<nowiki>+/-</nowiki>
| align="left" style="background:#F5F5F5;" + |
|<nowiki>-</nowiki>
* Absent [[cremasteric reflex]]
|<nowiki>-</nowiki>
* [[Testicle]] may be swollen, tender, and high−riding, with an abnormal transverse lie.
|<nowiki>+/-</nowiki>
| align="center" style="background:#F5F5F5;" + |Nl
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |Nl
|
| align="center" style="background:#F5F5F5;" + |−
* Absent cremasteric reflex
| align="center" style="background:#F5F5F5;" + |Nl
* Testicle may be swollen, tender, and high-riding, with an abnormal transverse lie.
| align="center" style="background:#F5F5F5;" + |Nl
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |−
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |Nl
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |Nl
|<nowiki>-</nowiki>
| align="left" style="background:#F5F5F5;" + |
|<nowiki>-</nowiki>
* [[Doppler ultrasound]] > [[Computed tomography|CT scan]] for diagnosis (absence of [[blood]] flow in the affected [[Testicle|testis]])
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|
* Doppler ultrasound > CT scan for diagnosis (abscence of blood flow in the affected testis)
|<nowiki>-</nowiki>
|-
|-
|Orchitis
! align="center" style="background:#DCDCDC;" + |[[Orchitis]]
|
| align="left" style="background:#F5F5F5;" + |
* Unprotected sexual intercourse
* Unprotected sexual intercourse
* Mumps, coxsackie virus infection
* [[Mumps]], [[Coxsackie virus|coxsackie]] virus infection
* Concurrent epididymitis
* [[Congenital disorder|Congenital abnornmalities]]
* Congenital abnornmalities
* [[Prostatic hypertrophy]] or [[calculi]]
* Prostatitis
| align="left" style="background:#F5F5F5;" + |
* Prostatic hypertrophy or calculi
* Abrupt onset of [[testicular pain]]
|<nowiki>+</nowiki>
| align="center" style="background:#F5F5F5;" + |<nowiki>+</nowiki>
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |−
|
| align="center" style="background:#F5F5F5;" + |−
* Abrupt onset of testicular pain
| align="center" style="background:#F5F5F5;" + |±
|<nowiki>+</nowiki>
| align="center" style="background:#F5F5F5;" + |<nowiki>+</nowiki>
|<nowiki>+</nowiki>
| align="center" style="background:#F5F5F5;" + |<nowiki>+</nowiki>
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |Nl
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |−
|<nowiki>-</nowiki>
| align="left" style="background:#F5F5F5;" + |
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>+/-</nowiki>
|<nowiki>-</nowiki>
|
* Testicular swelling and tenderness
* Testicular swelling and tenderness
* Normal cremasteric reflex
* Normal [[cremasteric reflex]]
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |Nl
|
| align="left" style="background:#F5F5F5;" + |
* Leukocytosis
* [[Leukocytosis]]
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |−
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |Nl
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |Nl
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |−
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |Nl
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |Nl
|<nowiki>-</nowiki>
| align="left" style="background:#F5F5F5;" + |
|
* [[Ultrasound]] > [[Computed tomography|CT scan]] for diagnosis ([[Scrotal mass|testicular masses]] or swollen [[testicles]] with hypoechoic and hypervascular areas)
* Ultrasound > CT scan for diagnosis (Testicular masses or swollen testicles with hypoechoic and hypervascular areas)
|-
|<nowiki>-</nowiki>
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Category
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Disease
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Risk factors
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Pain
! align="center" style="background:#4479BA; color: #FFFFFF;" + |N/V
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Anorexia
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Constipation
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Urinary symptoms
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Fever
! align="center" style="background:#4479BA; color: #FFFFFF;" + |HR
! align="center" style="background:#4479BA; color: #FFFFFF;" + |BP
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Tenderness
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Abdominopelvic exam
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Rectal exam
! align="center" style="background:#4479BA; color: #FFFFFF;" + |CBC
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Urinalysis
! align="center" style="background:#4479BA; color: #FFFFFF;" + |BUN
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Cr
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Urine Beta−hCG
! align="center" style="background:#4479BA; color: #FFFFFF;" + |LFT
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Serum amylase & lipase
! align="center" style="background:#4479BA; color: #FFFFFF;" + |CT
|-
|-
| rowspan="7" |Abdominal Pathology
! rowspan="8" align="center" style="background:#4479BA; color: #FFFFFF;" + |Abdominal pathology
|Cholecystitis
! align="center" style="background:#DCDCDC;" + |[[Cholecystitis]]
|
| align="left" style="background:#F5F5F5;" + |
* Female gender
* Female gender
* Obesity
* [[Obesity]]
* Pregnancy (increased progesterone promotes biliary stasis)
* [[Pregnancy]]
* Rapid weight loss
* Rapid [[weight loss]]
* Oral contraceptive use
* [[Total parenteral nutrition]]
* Increasing age
| align="left" style="background:#F5F5F5;" + |
* Total parenteral nutrition
* [[Right upper quadrant pain|Right upper abdominal quadrant pain]]
|<nowiki>+</nowiki>
* [[Flank pain]]
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |<nowiki>+</nowiki>
|
| align="center" style="background:#F5F5F5;" + |<nowiki>+</nowiki>
* Right upper abdominal quadrant pain
| align="center" style="background:#F5F5F5;" + |−
* Flank pain
| align="center" style="background:#F5F5F5;" + |−
|<nowiki>+</nowiki>
| align="center" style="background:#F5F5F5;" + |<nowiki>+</nowiki>
|<nowiki>+</nowiki>
| align="center" style="background:#F5F5F5;" + |<nowiki>+</nowiki>
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |Nl
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |−
|<nowiki>+</nowiki>
| align="center" style="background:#F5F5F5;" + |Nl
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |Nl
|<nowiki>-</nowiki>
| align="left" style="background:#F5F5F5;" + |
|<nowiki>-</nowiki>
* [[Leukocytosis]]
|<nowiki>-</nowiki>
| align="left" style="background:#F5F5F5;" + |
|<nowiki>-</nowiki>
* [[Bilirubin]] (pigment) stones
|<nowiki>-</nowiki>
* [[Cholesterol]] stones
|
| align="center" style="background:#F5F5F5;" + |Nl
* Leukocytosis
| align="center" style="background:#F5F5F5;" + |Nl
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |−
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |Might be abnormal
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |Might be abnormal
|
| align="left" style="background:#F5F5F5;" + |
* Bilirubin (pigment) stones
* [[Gallbladder]] distention
* Cholesterol stones
|<nowiki>-</nowiki>
|<nowiki>+</nowiki>
| +/-
|
* Gallbladder distention
* Wall thickening
* Wall thickening
* Mucosal hyperenhancement,
* Pericholecystic fat stranding or fluid
* Pericholecystic fat stranding or fluid
* Gallstones
* [[Gallstones]]
 
|<nowiki>-</nowiki>
|-
|-
|Appendicitis
! align="center" style="background:#DCDCDC;" + |[[Appendicitis]]
|
| align="left" style="background:#F5F5F5;" + |
* Male gender
* [[Adolescent|Adolescents]]
* Adolescents
* Diet low in fiber and high in refined [[carbohydrates]]
* Diet low in fiber and high in refined carbohydrates
| align="left" style="background:#F5F5F5;" + |
* History of appendicitis in first degree relatives
* [[Pain]] in umblical area
|<nowiki>+</nowiki>
* Radiating to [[Right lower quadrant abdominal pain resident survival guide|right lower abdominal quadrant]]
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |<nowiki>+</nowiki>
|
| align="center" style="background:#F5F5F5;" + |<nowiki>+</nowiki>
* Pain in umblical area
| align="center" style="background:#F5F5F5;" + |−
* Radiating to right lower abdominal quadrant
| align="center" style="background:#F5F5F5;" + |±
|<nowiki>+</nowiki>
| align="center" style="background:#F5F5F5;" + |<nowiki>+</nowiki>
|<nowiki>+</nowiki>
| align="center" style="background:#F5F5F5;" + |<nowiki>+</nowiki>
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |Nl
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |<nowiki>+</nowiki>
|<nowiki>+</nowiki>
| align="center" style="background:#F5F5F5;" + |Nl
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |Nl
|<nowiki>+</nowiki>
| align="left" style="background:#F5F5F5;" + |
|<nowiki>+/-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|
* Leukocytosis
* Leukocytosis
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |−
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |Nl
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |Nl
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |−
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |Nl
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + | Abnormal (if [[Perforation of inflamed diverticulum|perforation]])
| + (if perforation)
| align="left" style="background:#F5F5F5;" + |
|
* [[Vermiform appendix|Appendiceal]] wall thickening
* Larger than 6 mm in diameter,
* [[Phlegmon]]
* Appendiceal wall thickening
* [[Abscess]]
* Wall enhancement after contrast media infusion
* [[Adenopathy]]
* Inflammatory fat stranding
* Phlegmon
* Free fluid
* Free air bubbles
* Abscess
* Adenopathy
|<nowiki>-</nowiki>
|-
|-
|Diverticulitis
! align="center" style="background:#DCDCDC;" + |[[Diverticulitis]]
|
| align="left" style="background:#F5F5F5;" + |
* Diverticulosis
* [[Diverticulosis]]
* Low fiber diet
* Low [[Fiber|fiber diet]]
* Old age
* Old age
|<nowiki>+</nowiki>
| align="left" style="background:#F5F5F5;" + |
|<nowiki>-</nowiki>
* [[Left lower quadrant abdominal pain resident survival guide|Left lower abdominal quadrant]]
|
| align="center" style="background:#F5F5F5;" + |<nowiki>+</nowiki>
* Left lower abdominal quadrant
| align="center" style="background:#F5F5F5;" + |<nowiki>+</nowiki>
|<nowiki>+</nowiki>
| align="center" style="background:#F5F5F5;" + |<nowiki>+</nowiki>
|<nowiki>+</nowiki>
| align="center" style="background:#F5F5F5;" + |−
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |<nowiki>+</nowiki>
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |<nowiki>+</nowiki>
|<nowiki>+</nowiki>
| align="center" style="background:#F5F5F5;" + |Nl
|<nowiki>+</nowiki>
| align="center" style="background:#F5F5F5;" + |−
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |Nl
|<nowiki>-</nowiki>
| align="left" style="background:#F5F5F5;" + |
|<nowiki>-</nowiki>
* [[Bleeding]]
|<nowiki>-</nowiki>
* [[Rectal masses|Rectal mass]]
|
* [[Rectal]] [[tenderness]]
* Bleeding
| align="left" style="background:#F5F5F5;" + |
* Rectal mass
* [[Leukocytosis]]
* Rectal tenderness
| align="center" style="background:#F5F5F5;" + |−
|
| align="center" style="background:#F5F5F5;" + |Nl
* Leukocytosis
| align="center" style="background:#F5F5F5;" + |Nl
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |−
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |Nl
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + | Abnormal (if [[Perforation of inflamed diverticulum|perforation]])
|<nowiki>-</nowiki>
| align="left" style="background:#F5F5F5;" + |
|<nowiki>-</nowiki>
* [[Colon|Colonic]] wall thickening
|<nowiki>-</nowiki>
|<nowiki>+ (if perforation)</nowiki>
|
* Colonic wall thickening (wall thickness is greater than 3 mm on the short axis of the lumen)
* Pericolic fat stranding
* Pericolic fat stranding
|<nowiki>-</nowiki>
|-
|-
|Abdominal aortic aneurysm
! align="center" style="background:#DCDCDC;" + |[[Abdominal aortic aneurysm]]
|
| align="left" style="background:#F5F5F5;" + |
* Hypertension
* [[Cigarette smoking]]
* Cigarette smoking
* [[Hypertension]]
* Pulsatile abdominal mass
| align="left" style="background:#F5F5F5;" + |
|<nowiki>-</nowiki>
* [[Epigastric pain]]
|<nowiki>-</nowiki>
* Deep boring [[pain]] in the [[back]]
|
* May radiate to [[flank]]
* Epigastric pain
| align="center" style="background:#F5F5F5;" + |−
* Deep boring pain in the back
| align="center" style="background:#F5F5F5;" + |−
* May radiate to flank
| align="center" style="background:#F5F5F5;" + |−
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |−
|<nowiki>+</nowiki>
| align="center" style="background:#F5F5F5;" + |−
|<nowiki>+</nowiki>
| align="center" style="background:#F5F5F5;" + |<nowiki>+</nowiki>
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |Nl
|<nowiki>-</nowiki>
| align="left" style="background:#F5F5F5;" + |
|<nowiki>-</nowiki>
* Positive abdominal tenderness (if rupture)
|<nowiki>+ (if rupture)</nowiki>
| align="center" style="background:#F5F5F5;" + |
|<nowiki>-</nowiki>
* [[Pulsatile Flow|Pulsatile]] [[abdominal mass]]
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |Nl
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |−
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |−
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |Nl
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |Nl
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |−
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |Nl
|<nowiki>-</nowiki>
| align="center" style="background:#F5F5F5;" + |Nl
|<nowiki>-</nowiki>
| align="left" style="background:#F5F5F5;" + |
|<nowiki>-</nowiki>
* CT scan accurately predict the aneurysmal size
|<nowiki>-</nowiki>
|
* Ultrasound more sensitive than CT scan
* CT scan may accurately predict the aneurysmal size
* Helical CT has faster scanning time (30 to 60 seconds) and the ability to obtain all images in one breath hold
|<nowiki>-</nowiki>
|-
|-
|Portal vein thrombosis
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Disease
|
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Risk factors
* Mutated JAK2 V617F
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Pain
* Anti-phospholipid syndrome
! align="center" style="background:#4479BA; color: #FFFFFF;" + |N/V
* Paroxysmal nocturnal hemoglobinuria
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Anorexia
* Homocysteinuria
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Constipation
* Factor V Leiden
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Urinary symptoms
* Prothrombin mutation G20210A
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Fever
* Protein C or S deficiency
! align="center" style="background:#4479BA; color: #FFFFFF;" + |HR
* Oral contraceptive use
! align="center" style="background:#4479BA; color: #FFFFFF;" + |BP
* Cirrhosis
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Tenderness
* Pregnancy and post-partum
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Abdominopelvic exam
|<nowiki>+</nowiki>
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Rectal exam
|<nowiki>-</nowiki>
! align="center" style="background:#4479BA; color: #FFFFFF;" + |CBC
|
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Urinalysis
* Abdominal or lumbar pain
! align="center" style="background:#4479BA; color: #FFFFFF;" + |BUN
|<nowiki>+</nowiki>
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Cr
|<nowiki>+</nowiki>
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Urine Beta−hCG
|<nowiki>+</nowiki>
! align="center" style="background:#4479BA; color: #FFFFFF;" + |LFT
|<nowiki>-</nowiki>
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Serum amylase & lipase
|<nowiki>+</nowiki>
! align="center" style="background:#4479BA; color: #FFFFFF;" + |CT
|<nowiki>-</nowiki>
|<nowiki>+ (if bowel ischemia or infarction-secondary to extension of thrombus to superior mesenteric artery)</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|
* Hematochezia
|
* Anemia
* Thrombocytopenia
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>+</nowiki>
|<nowiki>+ (if bowel infarction, perforation)</nowiki>
|
* On non-contrast CT:
** Hyperdense thrombus
* On contrast CT
** Non-enhancing defect of bland thrombus
** Tumor thrombus exhibits enhancement
|
|-
|-
|Duodenal ulcer
! align="center" style="background:#DCDCDC;" + |[[Portal vein thrombosis]]
|
| align="left" style="background:#F5F5F5;" + |
* Helicobacter pylori infection
* Coagulopathies
* Tobacco smoking
* [[Oral contraceptive|Oral contraceptive use]]
* NSAID use
* [[Cirrhosis]]
* EtOH use
* [[Pregnancy]] and [[post-partum|post−partum]]
* Older age
| align="left" style="background:#F5F5F5;" + |
* Female gender
* [[Abdominal]] or [[lumbar pain]]
* Family history of duodenal ulcers
| align="center" style="background:#F5F5F5;" + |<nowiki>+</nowiki>
|
| align="center" style="background:#F5F5F5;" + |<nowiki>+</nowiki>
|
| align="center" style="background:#F5F5F5;" + |−
|
| align="center" style="background:#F5F5F5;" + |−
|
| align="center" style="background:#F5F5F5;" + |<nowiki>+</nowiki>
|
| align="center" style="background:#F5F5F5;" + |<nowiki>+</nowiki>
|
| align="center" style="background:#F5F5F5;" + |↓
|
| align="left" style="background:#F5F5F5;" + |
|
* Positive abdominal tenderness (if [[bowel]] [[ischemia]] or [[infarction]])
|
| align="center" style="background:#F5F5F5;" + |Nl
|
| align="left" style="background:#F5F5F5;" + |
|
* [[Hematochezia]]
|
| align="left" style="background:#F5F5F5;" + |
|
* [[Anemia]]
|
* [[Thrombocytopenia]]
|
| align="center" style="background:#F5F5F5;" + |−
|
| align="center" style="background:#F5F5F5;" + |Nl
|
| align="center" style="background:#F5F5F5;" + |Nl
|
| align="center" style="background:#F5F5F5;" + |−
|
| align="center" style="background:#F5F5F5;" + |Might be abnormal
|
| align="center" style="background:#F5F5F5;" + |Abnormal (if [[bowel]] [[infarction]], [[perforation]])
|
| align="left" style="background:#F5F5F5;" + |
|
* Hyperdense thrombus on non−contrast CT
|
* Non−enhancing defect of bland thrombus on contrast CT
|
|-
! align="center" style="background:#DCDCDC;" + |[[Duodenal ulcer]]
| align="left" style="background:#F5F5F5;" + |
* [[Helicobacter pylori infection]]
* [[Tobacco smoking]]
* [[NSAID|NSAID use]]
* [[Alcohol|EtOH use]]
| align="left" style="background:#F5F5F5;" + |
* [[Epigastric pain]] which relieved by intake of food
| align="center" style="background:#F5F5F5;" + |<nowiki>+</nowiki>
| align="center" style="background:#F5F5F5;" + |−
| align="center" style="background:#F5F5F5;" + |−
| align="center" style="background:#F5F5F5;" + |−
| align="center" style="background:#F5F5F5;" + |<nowiki>+</nowiki>
| align="center" style="background:#F5F5F5;" + |<nowiki>+</nowiki>
| align="center" style="background:#F5F5F5;" + |↓
| align="left" style="background:#F5F5F5;" + |
* Positive abdominal tenderness (if [[Bowel perforation|perforation]])
| align="center" style="background:#F5F5F5;" + |Nl
| align="left" style="background:#F5F5F5;" + |
* [[Melena]]
| align="left" style="background:#F5F5F5;" + |
* [[Anemia]]
| align="center" style="background:#F5F5F5;" + |−
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |−
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |Abnormal (if [[bowel perforation]])
| align="left" style="background:#F5F5F5;" + |
* [[Endoscopy]] > [[CT scan]] for diagnosis
|-
! align="center" style="background:#DCDCDC;" + |[[Ischemic colitis]]
| align="left" style="background:#F5F5F5;" + |
* Advanced age
* [[Hemodialysis]]
* [[Hypertension]]
* [[Diabetes mellitus]]
| align="left" style="background:#F5F5F5;" + |
* Acute−onset [[abdominal cramping]] 
| align="center" style="background:#F5F5F5;" + |<nowiki>+</nowiki>
| align="center" style="background:#F5F5F5;" + |<nowiki>+</nowiki>
| align="center" style="background:#F5F5F5;" + |<nowiki>+</nowiki>
| align="center" style="background:#F5F5F5;" + |−
| align="center" style="background:#F5F5F5;" + |<nowiki>+</nowiki>
| align="center" style="background:#F5F5F5;" + |<nowiki>+</nowiki>
| align="center" style="background:#F5F5F5;" + |↑ or ↓ (if [[necrosis]] or [[sepsis]])
| align="left" style="background:#F5F5F5;" + |
* Positive abdominal tenderness (if transmural [[necrosis]])
| align="center" style="background:#F5F5F5;" + |Nl
| align="left" style="background:#F5F5F5;" + |
* [[Hematochezia]]
| align="left" style="background:#F5F5F5;" + |
* [[Leukocytosis]] (if [[necrosis]])
* [[Anemia]] (if [[Gastrointestinal perforation|perforation]] and [[bleeding]])
| align="center" style="background:#F5F5F5;" + |−
| align="center" style="background:#F5F5F5;" + |Nl to ↑
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |−
| align="center" style="background:#F5F5F5;" + |Nl
| align="center" style="background:#F5F5F5;" + |Abnormal (if bowel [[perforation]])
| align="left" style="background:#F5F5F5;" + |
* [[Bowel]] wall thickening
* Thumbprinting
* [[Halo sign|Double halo]] or target sign 
* [[Submucosal]] [[edema]] or [[hemorrhage]]
* Pneumatosis coli (if infarction)
|-
|-
|Ischemic colitis
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Category
|
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Disease
* Age > 60 years
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Risk factors
* Hemodialysis
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Pain
* Hypertension
! align="center" style="background:#4479BA; color: #FFFFFF;" + |N/V
* Hypoalbuminemia
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Anorexia
* Diabetes mellitus
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Constipation
|
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Urinary symptoms
|
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Fever
|
! align="center" style="background:#4479BA; color: #FFFFFF;" + |HR
|
! align="center" style="background:#4479BA; color: #FFFFFF;" + |BP
|
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Tenderness
|
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Abdominopelvic exam
|
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Rectal exam
|
! align="center" style="background:#4479BA; color: #FFFFFF;" + |CBC
|
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Urinalysis
|
! align="center" style="background:#4479BA; color: #FFFFFF;" + |BUN
|
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Cr
|
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Urine Beta−hCG
|
! align="center" style="background:#4479BA; color: #FFFFFF;" + |LFT
|
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Serum amylase & lipase
|
! align="center" style="background:#4479BA; color: #FFFFFF;" + |CT
|
|
|
|
|
|
|
|
|
|}
|}
==References==
==References==
{{Reflist|2}}
{{Reflist|2}}


{{WH}}
[[Category:Medicine]]
{{WS}}
[[Category:Nephrology]]
[[Category: (name of the system)]]
[[Category:Urology]]
[[Category:Up-To-Date]]
[[Category:Emergency medicine]]

Latest revision as of 22:27, 29 July 2020

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Syed Hassan A. Kazmi BSc, MD [2] Amandeep Singh M.D.[3]

Overview

Nephrolithiasis should be differentiated from other conditions presenting with acute flank or upper abdominal pain, hematuria, nausea and vomiting.

Differentiating Nephrolithiasis from other Diseases

Nephrolithiasis should be differentiated from other conditions presenting with acute flank or upper abdominal pain, hematuria, nausea and vomiting. The differentials include the following:[1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34]

Category Disease Risk factors Symptoms Signs Paraclinical studies
Pain N/V Anorexia Constipation Urinary symptoms Fever HR BP Tenderness Abdominopelvic exam Rectal exam CBC Urinalysis BUN Cr Urine Beta−hCG LFT Serum amylase & lipase CT
Renal Pathology Nephrolithiasis + ± − + − ↑ Nl − Nl Nl Nl Nl Nl − Nl Nl
  • Radiolucent stone
Pyelonephritis + ± − + + ↑ ↓
  • Positive renal punch sign
  • Costovertebral angle tenderness
 Nl Nl Nl Might be + Nl Nl
  • Decreased contrast uptake
  • Foci from abscess pockets
Renal infarct + − − − + ↑ ↑ − Nl Nl Nl to ↑ Nl − Nl Nl
  • Decreased contrast uptake
Renal papillary necrosis − − − + + ± ↑ − Nl Nl Nl Nl to ↑ Nl − Nl Nl
Renal cell carcinoma + + ± − − − ↑ −
  • Flank mass
 Nl Nl Nl − Nl Nl
Urethral stricture − − − − + − − Nl − Nl Nl − Nl to ↑ Nl − Nl Nl Nl
Category Disease Risk factors Pain N/V Anorexia Constipation Urinary symptoms Fever HR BP Tenderness Abdominopelvic exam Rectal exam CBC Urinalysis BUN Cr Urine Beta−hCG LFT Serum amylase & lipase CT
Gynecological pathology Pelvic inflammatory disease
  • Right/left upper quadrant
 − + − + + + ↓ Nl Nl Nl Might be + Nl Nl
Ovarian torsion NA
  • Acute unilateral poorly localized lower abdominal sharp colicky pain aggravated by walking
 + − − − − + Nl − Nl − − − − − Nl Nl
  • Twisted and distended ovarian pedicle
  • Enlarged ovary (>4.0 cm)
Ectopic pregnancy + + − + − + ↓ (if ruptured)
  • Positive abdominal tenderness (if ruptured)
 Nl
  • Low platelet distribution width (decreased platelet activation)
  • Monocytosis
 − − − + Might be abnormal Nl NA
Category Disease Risk factors Pain N/V Anorexia Constipation Urinary symptoms Fever HR BP Tenderness Abdominopelvic exam Rectal exam CBC Urinalysis BUN Cr Urine Beta−hCG LFT Serum amylase & lipase CT
Prostate pathology Prostatitis − − − + + + Nl − Nl − − − Nl Nl
Prostatic cancer − − + − + − − Nl − Nl Nl Nl Nl − Nl Nl
Testicular pathology Testicular torsion + ± − ± − + Nl − Nl Nl − Nl Nl − Nl Nl
Orchitis + − − ± + + Nl − Nl − Nl Nl − Nl Nl
Category Disease Risk factors Pain N/V Anorexia Constipation Urinary symptoms Fever HR BP Tenderness Abdominopelvic exam Rectal exam CBC Urinalysis BUN Cr Urine Beta−hCG LFT Serum amylase & lipase CT
Abdominal pathology Cholecystitis + + − − + + Nl − Nl Nl Nl Nl − Might be abnormal Might be abnormal
Appendicitis + + − ± + + Nl + Nl Nl
  • Leukocytosis
 − Nl Nl − Nl Abnormal (if perforation)
Diverticulitis + + + − + + Nl − Nl − Nl Nl − Nl Abnormal (if perforation)
  • Colonic wall thickening
  • Pericolic fat stranding
Abdominal aortic aneurysm − − − − − + Nl
  • Positive abdominal tenderness (if rupture)
 Nl − − Nl Nl − Nl Nl
  • CT scan accurately predict the aneurysmal size
Disease Risk factors Pain N/V Anorexia Constipation Urinary symptoms Fever HR BP Tenderness Abdominopelvic exam Rectal exam CBC Urinalysis BUN Cr Urine Beta−hCG LFT Serum amylase & lipase CT
Portal vein thrombosis + + − − + + ↓ Nl − Nl Nl − Might be abnormal Abnormal (if bowel infarction, perforation)
  • Hyperdense thrombus on non−contrast CT
  • Non−enhancing defect of bland thrombus on contrast CT
Duodenal ulcer + − − − + + ↓ Nl − Nl Nl − Nl Abnormal (if bowel perforation)
Ischemic colitis + + + − + + ↑ or ↓ (if necrosis or sepsis)
  • Positive abdominal tenderness (if transmural necrosis)
 Nl − Nl to ↑ Nl − Nl Abnormal (if bowel perforation)
Category Disease Risk factors Pain N/V Anorexia Constipation Urinary symptoms Fever HR BP Tenderness Abdominopelvic exam Rectal exam CBC Urinalysis BUN Cr Urine Beta−hCG LFT Serum amylase & lipase CT

References

  1. ↑ Worcester EM, Coe FL (June 2008). "Nephrolithiasis". Prim. Care. 35 (2): 369–91, vii. doi:10.1016/j.pop.2008.01.005. PMC 2518455. PMID 18486720.
  2. ↑ Semins MJ, Matlaga BR (February 2010). "Medical evaluation and management of urolithiasis". Ther Adv Urol. 2 (1): 3–9. doi:10.1177/1756287210369121. PMC 3126068. PMID 21789078.
  3. ↑ Venkatesh L, Hanumegowda RK (June 2017). "Acute Pyelonephritis - Correlation of Clinical Parameter with Radiological Imaging Abnormalities". J Clin Diagn Res. 11 (6): TC15–TC18. doi:10.7860/JCDR/2017/27247.10033. PMC 5535453. PMID 28764263.
  4. ↑ Garin EH, Olavarria F, Araya C, Broussain M, Barrera C, Young L (July 2007). "Diagnostic significance of clinical and laboratory findings to localize site of urinary infection". Pediatr. Nephrol. 22 (7): 1002–6. doi:10.1007/s00467-007-0465-7. PMID 17375337.
  5. ↑ Lee DG, Jeon SH, Lee CH, Lee SJ, Kim JI, Chang SG (April 2009). "Acute pyelonephritis: clinical characteristics and the role of the surgical treatment". J. Korean Med. Sci. 24 (2): 296–301. doi:10.3346/jkms.2009.24.2.296. PMC 2672131. PMID 19399273.
  6. ↑ Saeed K (2012). "Renal infarction". Int J Nephrol Renovasc Dis. 5: 119–23. doi:10.2147/IJNRD.S33768. PMC 3437809. PMID 22969301.
  7. ↑ Mahamid M, Francis A, Abid A, Awawde M, Abu-Elhija O (2014). "Embolic renal infarction mimicking renal colic". Int J Nephrol Renovasc Dis. 7: 157–9. doi:10.2147/IJNRD.S59745. PMC 4011809. PMID 24812524.
  8. ↑ Korzets Z, Plotkin E, Bernheim J, Zissin R (October 2002). "The clinical spectrum of acute renal infarction". Isr. Med. Assoc. J. 4 (10): 781–4. PMID 12389340.
  9. ↑ Brix AE (2002). "Renal papillary necrosis". Toxicol Pathol. 30 (6): 672–4. doi:10.1080/01926230290166760. PMID 12512867.
  10. ↑ Eknoyan G, Qunibi WY, Grissom RT, Tuma SN, Ayus JC (March 1982). "Renal papillary necrosis: an update". Medicine (Baltimore). 61 (2): 55–73. PMID 7038374.
  11. ↑ Ng CS, Wood CG, Silverman PM, Tannir NM, Tamboli P, Sandler CM (October 2008). "Renal cell carcinoma: diagnosis, staging, and surveillance". AJR Am J Roentgenol. 191 (4): 1220–32. doi:10.2214/AJR.07.3568. PMID 18806169.
  12. ↑ Ares Valdés Y, Amador Sandoval B, Morales JC, Alonso Domínguez F, Carballo Velásquez L, Fragas Valdés R, Shou Rodríguez A (September 2004). "[The role of CT scan in the diagnosis of renal cell carcinoma]". Arch. Esp. Urol. (in Spanish; Castilian). 57 (7): 737–42. PMID 15536955.
  13. ↑ Leveridge MJ, Bostrom PJ, Koulouris G, Finelli A, Lawrentschuk N (June 2010). "Imaging renal cell carcinoma with ultrasonography, CT and MRI". Nat Rev Urol. 7 (6): 311–25. doi:10.1038/nrurol.2010.63. PMID 20479778.
  14. ↑ Tritschler S, Roosen A, Füllhase C, Stief CG, Rübben H (March 2013). "Urethral stricture: etiology, investigation and treatments". Dtsch Arztebl Int. 110 (13): 220–6. doi:10.3238/arztebl.2013.0220. PMC 3627163. PMID 23596502.
  15. ↑ Mundy AR, Andrich DE (January 2011). "Urethral strictures". BJU Int. 107 (1): 6–26. doi:10.1111/j.1464-410X.2010.09800.x. PMID 21176068.
  16. ↑ Maciejewski C, Rourke K (February 2015). "Imaging of urethral stricture disease". Transl Androl Urol. 4 (1): 2–9. doi:10.3978/j.issn.2223-4683.2015.02.03. PMC 4708283. PMID 26816803.
  17. ↑ Soper DE (August 2010). "Pelvic inflammatory disease". Obstet Gynecol. 116 (2 Pt 1): 419–28. doi:10.1097/AOG.0b013e3181e92c54. PMID 20664404.
  18. ↑ Paavonen J (October 1998). "Pelvic inflammatory disease. From diagnosis to prevention". Dermatol Clin. 16 (4): 747–56, xii. PMID 9891675.
  19. ↑ Lee MH, Moon MH, Sung CK, Woo H, Oh S (December 2014). "CT findings of acute pelvic inflammatory disease". Abdom Imaging. 39 (6): 1350–5. doi:10.1007/s00261-014-0158-1. PMID 24802548.
  20. ↑ Eggert J, Sundquist K, van Vuuren C, Fianu-Jonasson A (October 2006). "The clinical diagnosis of pelvic inflammatory disease--reuse of electronic medical record data from 189 patients visiting a Swedish university hospital emergency department". BMC Womens Health. 6: 16. doi:10.1186/1472-6874-6-16. PMC 1624808. PMID 17054801.
  21. ↑ Washington C, Carmichael JC (December 2012). "Management of ischemic colitis". Clin Colon Rectal Surg. 25 (4): 228–35. doi:10.1055/s-0032-1329534. PMC 3577613. PMID 24294125.
  22. ↑ Chawla YK, Bodh V (March 2015). "Portal vein thrombosis". J Clin Exp Hepatol. 5 (1): 22–40. doi:10.1016/j.jceh.2014.12.008. PMC 4415192. PMID 25941431.
  23. ↑ "Imaging of Abdominal Aortic Aneurysms - - American Family Physician".
  24. ↑ Aggarwal S, Qamar A, Sharma V, Sharma A (2011). "Abdominal aortic aneurysm: A comprehensive review". Exp Clin Cardiol. 16 (1): 11–5. PMC 3076160. PMID 21523201.
  25. ↑ Destigter KK, Keating DP (August 2009). "Imaging update: acute colonic diverticulitis". Clin Colon Rectal Surg. 22 (3): 147–55. doi:10.1055/s-0029-1236158. PMC 2780264. PMID 20676257.
  26. ↑ Hameed AM, Lam VW, Pleass HC (February 2015). "Significant elevations of serum lipase not caused by pancreatitis: a systematic review". HPB (Oxford). 17 (2): 99–112. doi:10.1111/hpb.12277. PMC 4299384. PMID 24888393.
  27. ↑ "Imaging for Suspected Appendicitis - - American Family Physician".
  28. ↑ "CT Findings of Acute Cholecystitis and Its Complications : American Journal of Roentgenology : Vol. 194, No. 6 (AJR)".
  29. ↑ "Epididymitis and Orchitis: An Overview - - American Family Physician".
  30. ↑ Jia JB, Houshyar R, Verma S, Uchio E, Lall C (January 2016). "Prostate cancer on computed tomography: A direct comparison with multi-parametric magnetic resonance imaging and tissue pathology". Eur J Radiol. 85 (1): 261–267. doi:10.1016/j.ejrad.2015.10.013. PMID 26526901.
  31. ↑ Bratt O, Lilja H (January 2015). "Serum markers in prostate cancer detection". Curr Opin Urol. 25 (1): 59–64. doi:10.1097/MOU.0000000000000128. PMC 4315142. PMID 25393274.
  32. ↑ "Prostate Cancer (Prostate Carcinoma): Symptoms - National Library of Medicine - PubMed Health".
  33. ↑ Eskicioğlu F, Özdemir AT, Turan GA, Gür EB, Kasap E, Genç M (November 2014). "The efficacy of complete blood count parameters in the diagnosis of tubal ectopic pregnancy". Ginekol. Pol. 85 (11): 823–7. PMID 25675798.
  34. ↑ Sivalingam VN, Duncan WC, Kirk E, Shephard LA, Horne AW (October 2011). "Diagnosis and management of ectopic pregnancy". J Fam Plann Reprod Health Care. 37 (4): 231–40. doi:10.1136/jfprhc-2011-0073. PMC 3213855. PMID 21727242.
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