Calf Pain

Question 1

PE relevant exam

Answer 1

Lower limb

• Inspection
• Assess for temperature
• Palpate the peripheral pulses bilaterally
• Assess for pitting edema
• Assess for capillary refill
• Buerger’s Test

Question 2

additional exam

Answer 2

1. BP, HR, RR

2. Ascultate for S1 and S2

Question 3

Questions to ask:

Answer 3

any changes in skin, such as dryness and hair loss?

any discoloured limbs?

numbness, weakness?

Question 4

Differentials

Answer 4

• DVT
• Cellulitis
• Peripheral Artery disease
• Beurger’s disease
• Popliteal artery entrapment
• Spinal stenosis

Question 5

Deep Vein Thrombosis

Answer 5

• pitting edema
• acute onset
• UNILATERAL leg swelling and pain
• immobilization, surgery, smoker, oral contraceptive

Question 6

Cellulitis

Answer 6

• acute
• unilateral leg swelling, pain
• redness, warmth
• fever

Question 7

PAD

Answer 7

• intermittent claudication (pain when active, better at rest)
• worse with exercise
• pale, dry skin with hair loss
• older age

Question 8

Beurger’s disease

Answer 8

• smoking
• leg pain w exercise
• raynauds phenomenon (blue fingertips/cold)

Question 9

Popliteal artery entrapment

Answer 9

• intermittent claudication
• cramping pain in calf with exercise
• young
• athlete

Question 10

Spinal stenosis

Answer 10

• major trauma
• pain relieved by leaning forward
• pain on rest
• numbness in lower limb

Question 11

Plan

Answer 11

Ultrasound
D dimer levels
Venogram
Ankle brachial index*