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Occasionally back pain can originate from other structures. Let us consider some of the structures lying on the posterior abdominal wall. A common example is pyelonephritis. Other features of the history, such as acute onset fever, nausea and dysuria, usually make the diagnosis obvious.
In rare instances, leaking abdominal aortic aneurysm or an embolus across the bifurcation of the abdominal aorta (saddle embolus) can be mistaken for musculoskeletal pain with catastrophic consequences.