A 56 year old female comes into the clinic complaining of intermittent severe pain that radiates from the flank to the groin and sometimes to the inner thigh. Upon further questioning she tells you that she has an urge to always go to the restroom and that she sometimes sweats and feels nauseous. A urinalysis provide traces of blood, a few white blood count and no bacteria.
1) what is your differential diagnosis?
2) Discuss in detail the pathophysiology of each item in your differential and how it might fit in describing this case.
3) The X-ray comes back and there is nothing abnormal except slightly dilated ureter. Does this change your differential or narrow it?
4) How would you treat the pain in his case?