A patient presented with pain abdomen, X-Ray, AP view shows calcification on right side of abdomen. In lateral view calcification is seen to overlie the spine. What is the most likely diagnosis?
**Core Concept**
The patient's presentation of abdominal pain and radiographic evidence of calcification overlying the spine on a lateral X-ray view suggests a specific anatomical location of a calcified structure. The calcification is likely located in the right lower quadrant of the abdomen, which is a common location for certain types of calcified lesions.
**Why the Correct Answer is Right**
The most likely diagnosis is a right psoas abscess or a calcified kidney stone, but given the specific location and the fact that the calcification overlies the spine, the diagnosis of a right psoas abscess is less likely. The calcification is more likely due to a calcified kidney stone, specifically a staghorn calculus, which is a type of kidney stone that is large and irregular in shape. Staghorn calculi are often composed of magnesium ammonium phosphate and are associated with urinary tract infections.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect because a right psoas abscess would not typically present with calcification on an X-ray. While a psoas abscess can cause pain and may have some radiographic abnormalities, calcification is not a typical feature.
**Option B:** This option is incorrect because a Meckel's diverticulum is a congenital anomaly of the small intestine and would not typically present with calcification on an X-ray. While a Meckel's diverticulum can cause abdominal pain, it is not associated with calcification.
**Option C:** This option is incorrect because a splenic calcification is not typically seen in the right lower quadrant of the abdomen and would not overlie the spine on a lateral X-ray view.
**Clinical Pearl / High-Yield Fact**
Remember that staghorn calculi are often associated with urinary tract infections and are typically composed of magnesium ammonium phosphate. They can cause significant morbidity if not treated promptly.
**Correct Answer: D.**