The Painful Leg

Question 1

What’re the common causes of leg pain?

Answer 1

Arthritis

Sciatica

Cellulitis

DVT

Rarer causes (ischaemia, ruptured baker cyst, malignancy)

Question 2

What should be assessed in the general examination for leg pain?

Answer 2

Temperature

For an embolic cause - AF, murmurs, HF, aortic aneurysm)

For pulmonary emboli - HR, O2 sat, RR)

Urine - for glucose

Question 3

What’s the gold standard for diagnostic imaging in a DVT?

Answer 3

Only do be conducted in those with a raised D-dimer

Venography (painful)

Question 4

What characteristics indicate atrial disease as the cause of a painful leg?

Answer 4

Presents as intermittent claudication - pain felt in the calves or buttocks, brought on by exercise and rapidly relieved by rest