RIF Pain

Question 1

Describe the clinical picture in a testicular torsion

Answer 1

Knawing pain in testicles and IF

Question 2

What are some DDx for RIF pain?

Answer 2

Appendicitis

Crohn’s (terminal ileitis)

Mesenteric adenitis

Meckel’s

Diverticulitis

Ruptured ovarian cyst

Ovarian torsion

Ectopic pregnancy

Testicular torsion

Pyelonephritis

PID

Renal colic

MSK

Rectus sheath haematoma

Shingles

Psoas abscess

Cancer

Question 3

Describe the clinical picture in renal colic

Answer 3

Sudden onset

Wavy, severe pain

Macro/micro haematuria

Question 4

Describe the pain in a ruptured ovarian cyst

Answer 4

Rapid onset

Can be severe

Localises to the same side as the rupture

Pain remains until the fluid is resorbed

Question 5

What are the three sites of renal caliculi blockage?

Answer 5

Pelvic-ureteric junction

Pelvic brim

Vesicoureteric junction

Question 6

Describe the clinical picture in PID

Answer 6

Can cause generalised peritonitis/sepsis

Question 7

Describe the clinical picture in mesenteric adenitis

Answer 7

Viral infection causing lymphadenopathy in the mesentery = pain

Preceding viral illness

Question 8

Describe the clinical picture in a pyelonephritis including CT findings

Answer 8

Flank pain

Tender kidneys on palpation

Not necessarily lower UTI symptoms (can be primary)

Perinephric straining on CT

Question 9

Describe the clinical picture in Meckel’s diverticulum

Answer 9

Diverticulitis within 2 feet of the terminal ileum due to gastric and pancreatic metaplasia of the epithelium

GIT bleeding (melena) in a young person

Question 10

Describe the pain in a ovarian torsion?

Answer 10

Acute onset

Typically in premenopausal women with big cysts or other masses

Pain due to ischaemia

Question 11

Describe the clinical picture in a Crohn’s

Answer 11

Longer hx of pain

Knawing pain

Ass feature: weight loss, change in bowel habbit, anaemia

Other causes of terminal ileitis - TB, Yersinia