Emergency differential diagnosis of dysmenorrhea

Disease Symptoms Examination
Dysmenorrhea Cyclic lower abdominal pain or pain radiating to the lower back before or during menstruation Primary dysmenorrhea without organic lesions
Ectopic Pregnancy Sudden decrease in menstrual flow, irregular vaginal bleeding, sudden lower abdominal pain, often with a history of amenorrhea Positive blood hCG, ultrasound shows no gestational sac in the uterus, mass beside the uterus
Intrauterine Pregnancy Loss Lower abdominal heaviness, slight vaginal bleeding, history of amenorrhea Positive blood hCG, ultrasound shows gestational sac in the uterus
Corpus Luteum Rupture Sudden pain on one side of the lower abdomen after ovulation Negative blood hCG, lower abdominal tenderness and rebound pain, ultrasound indicates pelvic hemorrhage
Ovarian Cyst Torsion History of ovarian cyst, sudden severe one-sided lower abdominal pain on position change Negative blood hCG, lower abdominal tenderness and rebound pain, ultrasound shows adnexal mass
Pelvic Inflammatory Disease Lower abdominal pain with increased vaginal discharge Cervical motion tenderness, uterine tenderness, adnexal thickening and tenderness, or palpable painful mass
Acute Appendicitis Persistent pain migrating from upper abdomen to right lower abdomen, accompanied by nausea and vomiting Right lower abdominal tenderness, rebound pain, and muscle rigidity