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 tell you that she has an urge to always go to the restroom and that she sometime sweats and feels nauseous. A urinalysis provides traces of blood, a few white blood cells and no bacteria.
• What is your differential diagnosis? Discuss in detail the pathophysiology of each item in your differential and how it might fit in describing this case.
• The x-ray comes back and there is nothing abnormal except a slightly dilated ureter. Does this change your differential or narrow it?
• How would you treat the pain in this case?