Limb pain DDx
Limb pain – Differential Diagnosis
Common causes
- Soft tissue injury
- Muscle cramps
- Osteoarthritis
- Varicose veins
- Lumbar disc disease
- Gout
- Shin splints
- Complex regional pain syndrome
Must Not Miss
- Fracture
- Spinal cord compression
- Vascular
- Infections
- Compartment syndrome
- Malignancy
- Rhabdomyolysis
Easily missed
- Medication (e.g. Statins)
- Polymyalgia rheumatica
- Vitamin D deficiency
- Ruptured Baker’s cyst
- Spinal canal stenosis
- Neuropathy
Red flags
- Bilateral leg pain with bowel/bladder dysfunction
- Cold pulse less leg
- Hot/painful/swollen joint with little movement
- Unilateral calf pain, swelling and tenderness
- Risk factors for DVT
- Swelling of the entire leg
- Severe progressive pain
- Systemic symptoms (fever, weight loss)
- Immunosuppression
Investigations to consider
- FBC, CRP/ESR, D-dimers
- U&Es, LFTs, Blood glucose,
- Serum uric acid, bone profile, CK, Vitamin D
- Local X-ray
- Duplex USS
- Venography
- Angiography
- Nerve conduction studies
- MRI scan