Calf pain DDx

Calf pain – Differential Diagnosis

Common causes

• Soft tissue injury
• Muscle cramps
• Cellulitis
• Knee osteoarthritis
• Thrombophlebitis
• Lumbar disc disease
• Restless legs

Must Not Miss

• Compartment syndrome
• Septic arthritis
• Vascular
  • DVT
  • Acute ischaemia
  • Intermittent claudication
• Malignancy
• Limping child DDx

Easily missed

• Medication (e.g. Statins)
• Electrolyte disturbance
• Ruptured Baker’s cyst
• Painful polyneuropathy

Red flags

• Cold pulseless leg
• Unilateral pain/tenderness and swelling
• Risk factors for DVT
• Swelling of the entire leg
• Acute chest pain, Dyspnoea or Haemoptysis
• Severe progressive pain
• Systemic symptoms (fever, weight loss)
• Immunosuppression

Investigations to consider

• FBC, CRP/ESR, D-dimer
• U&Es, LFTs, Blood glucose, bone profile
• Local X-ray
• Duplex USS
• Venography
• Angiography
• MRI scan (lumbar spine)