A 56-year-old male anatomy professor at a well-known university in North Hollywo

Question

A 56-year-old male anatomy professor at a well-known university in North Hollywood was brought to the emergency room at the UCLA Ronald Reagan Medical Center. His chief complaint was right flank pain. History of present Illness: One day prior to admission, the patient developed a change in the color of his urine from pale yellow to red in color. There was no associated fever, painful urination, or penile discharge. He decided to consult with his primary physician the following day. One hour prior to admission, the patient developed severe right flank pain associated with nausea. His wife was brought him to the UCLA Ronald Reagan Medical Center. Upon admission, the patient was noted by the ER physician to be in severe pain, with a pain scale of 9 from a visual analog pain scale from 1 to 10. On physical exam, patient had the following findings: Vital Signs BP: 140/90 Heart rate: 110/minute Respiration rate: 15/minute patient was afebrile All exam findings for the head, neck, heart, lungs, and abdomen were normal. On examination of the back, patient had tenderness on the right flank upon palpation. On examination of the genitalia, there was no penile discharge. Note of a 1 x 1 cm tophus on right big toe. The following diagnostic exams were ordered: CBC with WBC differential count Urinalysis Serum uric acid KUB x-ray MRI Scan abdominopelvic area He was immediately injected by IV with a strong analgesic to relieve the pain. Past Medical History: Diagnosed with gout one year prior to admission On medication with allopurinol No heart and lung disease No diabetes or hypertension

Explanation / Answer

Flank pain:

Flank is the region in the body which lies between the hip and the last rib. Pain in Flank is mostly associated with strain in muscles, back strain or sprain which is commonly linked with the kidneys, ureters, or bladder such as pyelonephritis, kidney stone, and renal abscesses. It may possible with other regions for flank pain such as gastrointestinal disorders, blood clots, herpes zoster infection, radiculitis, arthritis or infection of the spine, disc disease. Flank pain may be symptoms of several serious conditions such as kidney cancer, Kidney disease, Diverticulitis, Gallbladder disease, Appendicitis and Blockage in the urinary tract. Flank pain is tricky which should be diagnose and require some different tests to find out the problem.

The positions of flank pain:

The position of the flank pain depends on the underlying cause and it varies from moderate to acute and usually worsens with movement. Flank pain in right side represents major problems in the right kidney whereas a flank pain in left side indicates a pain in the left kidney. Sometimes minor condition can arise to a moderate pain in the flank region which can worsen with enlarged body movements. In men the flank pain region would be spread towards the downward direction and results in testicular pain. Treatment for flank pain includes rest, physical therapy, exercise, drinking more fluids, analgesics, anti-inflammatory drugs and antibiotics. Sometimes severe pain in the flank region is a dull or continuous and may be persist up to several months. This may be linked with persisting kidney problems like kidney stones, kidney abscesses, kidney tumors, kidney cysts, kidney infection (acute pyelonephritis) and glomerulonephritis.

There are also some other symptoms which associated with flank pain includes Abdominal pain. Fever. Chills, Frequent urination, Muscular tenderness, Nausea, Pain and discomfort while passing urine, Vomiting, Hematuria.

Investigations for Flank Pain:

These are the investigations for Flank Pain which are as follow: Abdominal CT scan, Retrograde ureteropyelography, Urine culture, Urinalysis, Voiding cystourethrography, Cytoscopy, Ultrasound examination of the abdomen or the kidney, Intravenous pyelography, Lumbosacral spine x-ray, Blood tests.

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