Leg pain

Question 1

Common causes of leg pain

Answer 1

1. Nerve entrapment - radiating, burning, ↑with rest, worse at night
2. Claudication - spinal canal stenosis, artery occlusion

*mc site for acute artery occlusion
Common femoral artery
Rx with in 4hrs, max 6hrs mandatory

Vascular occlusions - pain felt distal to occlusion

Question 2

Neurogenic vs Vascular claudication

Answer 2

Neurogenic:
1. >50yrs, long h/o back pain
2. Spinal canal stenosis
3. *Pain - proximal, radiates distally
4. Weakness, numbness, tingling
5. On walking up/downhill, prolonged standing
6. Pain ↓ with lying down
7. A/w bowel bladder symp
8. Best inv - MRI (spinal canal stenosis)
EMG

Vascular:
1. >50yrs
2. Arterial occlusion - aorto-iliac, common femoral etc
3. *Pain - distal, radiates proximally
4. Cramping, aching, squeezing
5. On walking for a certain time
6. pain ↓ with rest, standing still
7. A/w impotence
8. *Initial- Ankle brachial index … Duplex arterial USG
Best- CT - angio

Question 3

**Radiculopathy of L3, L4, L5, S1