In the ED, their vitals/exam are as above. Ddx includes ascending urinary tract infection, postoperative infection, RP hematoma, lumbar strain, lumbar bruise, and sciatica. Lower suspicion for aortic dissection considering pain was not acute in onset and vital signs are stable fracture considering lack of focal midline TTP, cord compression considering lack of weakness/foot drop, cauda equina considering lack of bilateral radiculopathy/bowel or bladder incontinence/saddle sensory loss, epidural abscess considering lack of IVDU/point TTP, PE as patient is without tachycardia/hypoxia/respiratory distress.
– Labs/Tests: Lactate, CBC, CMP, lipase, coags, blood cultures, UA, urine culture
– Imaging: CT abdomen and pelvis without contrast, consider CTA
– Treatments: IVF, symptom control, consider antibiotics
– Consults: Urology
– Dispo: Pending further testing