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Leg pain

  • Common ddx

    • erythema nodosum (post-infection, Crohns), cellulitis, trauma
  • Serious ddx

    • DVT, fracture, cauda equina, vascular claudication, septic arthritis
  • Labs

    • CBC, culture if cellulitis/infection
    • ESR
    • doppler US if DVT
    • joint aspiration if suspect septic arthritis
    • xray if trauma
    • MRI if neuro symptoms
  • Skin ddx

    • erythema nodosum, cellulitis, contact dermatitis
  • Muscle ddx

    • strain, sprain
  • Bone ddx

    • fracture, osteomyelitis, bone tumor, Paget disease
  • Knee ddx

    • torn meniscus, hemarthrosis, torn ligament, arthritis, prepatellar bursitis, septic arthritis
  • Just below the knee ddx

    • Osgood Schlatter
  • Behind the knee ddx

    • baker cyst, claudication
  • Hip ddx

    • arthritis
  • Vascular ddx

    • claudication, venous claudication, DVT
  • Neuro ddx

    • nerve root compression, spinal stenosis, cauda equina, conus medullaris, neuropathy
  • HPI

    • onset: acute vs chronic, new vs old
    • location: unilateral vs bilateral, where on the leg
    • quality
    • quantity
    • aggravation
    • alleviation
    • pain currently
    • ability to walk
  • ROS

    • trauma
    • fever, wt loss
    • rash, erythema nodosum
    • arthralgia
    • abdominal pain, nausea, vomiting, diarrhea, constipation, blood in stool
    • recent infection
    • back pain, incontinence, paresthesia
  • PMH

    • Crohns, IBD, cellulitis, Diabetes
  • SH

    • work-related trauma, B12 in diet
  • Px

    • abdominal exam
    • inspection: rash, erythema nodosum, deformity, bruising
    • palpation: tenderness, blanching, raised vs flat
    • strength, reflex
    • sensation
    • ROM
    • calf tenderness
    • Homan's sign: ankle dorsiflexion triggers pain
    • gait

  • Print | Citations

    Disclaimer: MDHero Workups is for educational use only, and is not meant to replace the clinical judgement of a professional. We do not guarantee the accuracy of any information on this website.