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leg pain
Etiology:
1) calf pain
3) compartment syndrome
4) ischemia
- peripheral arterial disease, intermittent claudication
5) traumatic leg injury
a) torn or overstretched muscle (strain)
b) stress fracture
c) tendonitis
d) shin splints
6) lumbar spinal stenosis
7) sciatica
8) muscle cramp (charley horse)
a) dehydration
b) electrolyte depletion
1] hypokalemia
2] hyponatremia
3] hypocalcemia
4] hypomagnesemia
9) statin myopathy
10) muscle fatigue or strain from overuse
11) holding a muscle in the same position for a long time
12) deep vein thrombosis
13) infection
a) osteomyelitis
b) cellulitis
14) arthritis, gout
15) peripheral neuropathy
16) varicose veins
17) benign tumors or cysts of the femur or tibia
- osteoid osteoma
18) Legg-Calve-Perthes disease: poor blood flow to the hip
19) malignant bone tumors
a) osteosarcoma
b) Ewing sarcoma
20) slipped capital femoral epiphysis (boys & overweight children 11-15 years old
21) Baker's cyst
22) fibromyalgia
23) also see hip pain, knee pain, calf pain, ankle pain, heel pain, foot pain
Clinical manifestations:
- red flags
a) painful leg is swollen or red
b) fever
c) pain worsens when walking or exercising & improves with rest
d) leg is black and blue
e) leg is cold & pale
Laboratory:
- clinical laboratory tests for specific diseases
- bone biopsy if potentially malignant tumor is seen on MRI
Special laboratory:
- ultrasound, doppler to evaluate DVT
Radiology:
1) arteriogram to check blood flow
2) bone scan
3) MRI or computed tomography
a) malignant tumor suspected
b) compartment syndrome
4) X-ray of your back or legs for suspected
a) sciatica (back)
b) fracture
c) arthritis
Management:
- see specific etiology
- RICED: rest, ice, compression, elevation, drugs
- stretch & massage cramping muscles
- control of diabetes or other contributing disorder
- stop smoking
- avoid ill-fitting shoes
Related
claudication
compartment syndrome
hip pain
nocturnal leg cramp
traumatic leg injury
Specific
ankle pain
calf pain
foot pain
knee pain
lower leg joint pain
shin splints; anterior tibial syndrome; medial tibial stress syndrome
thigh pain
General
limb pain
References
- Medical Knowledge Self Assessment Program (MKSAP) 11, 17.
American College of Physicians, Philadelphia 1998, 2015
- Berger D.
Leg discomfort: beyond the joints.
Med Clin North Am. 2014 May;98(3):429-44. Review.
PMID: 24758955
- Medline Plus: Leg pain
http://www.nlm.nih.gov/medlineplus/ency/article/003182.htm
- Mayo Clinic: Leg pain
http://www.mayoclinic.com/health/leg-pain/MY00080