Leg Pain

HISTORY:

‍RightLeft leg pain for ‍ ‍hoursdays

Onset: ‍gradualsuddentraumatic, following ‍ ‍

Location: ‍diffuse

Radiation: ‍none

Severity: ‍mildmoderatesevere, ‍012345678910 / 10

Type: ‍dullaching

Pattern: ‍constantintermittent, ‍worse at night

Worsening factors: ‍noneweight bearingwalking

‍weakness

‍numbness

‍tingling

‍swelling

‍warmth

‍redness

‍fever, up to ‍°, over ‍ ‍hoursdays

‍chills

‍skin changes

‍thickened or discolored nails

‍slow-healing wounds

Treatments tried: ‍none, ‍effectiveineffective

Occupation: ‍



EXAM:

General appearance: ‍well-appearing

Vital signs: ‍normal, BP ‍, HR ‍, RR ‍, SpO2 ‍ %, Temp ‍°

Neck: ‍normallymphadenopathy

Heart: ‍RRR, ‍normal S1 and S2

Lungs: ‍clearabnormal sounds, ‍retractions

Abdomen: ‍softsemi-softtense, ‍non-tender ‍, ‍non-distended, ‍

Skin: ‍no rash

Extremities: ‍edema, ‍warm, cap refill ‍< 3 sec> 3 sec, pulses ‍normal, ‍

Musculoskeletal: joints ‍ ‍normal, ‍no limited ROM

Lumbar spine: ‍no tenderness on ‍, range of motion ‍fulllimited

Hip: ‍rightleft: ‍no tenderness on ‍, range of motion ‍fulllimited

Knee: ‍rightleft: ‍no tenderness on ‍, range of motion ‍fulllimited

Ankle: ‍rightleft: ‍no tenderness on ‍, range of motion ‍fulllimited

Foot: ‍rightleft: ‍no tenderness on ‍, range of motion ‍fulllimited



ASSESSMENT:

‍Sciatica ‍likelysuspectedpossible

DDx: ‍



PLAN:

- X-ray

- MRI

- Doppler ultrasound

- CT-angio of the legs

- Bone scan

- Blood work: ‍CBC, ‍CRP, ‍ESR, ‍D-dimer, ‍CK, ‍vitamin D, ‍uric acid

- Rest and elevation

- Heat or cold therapy

- ‍Acetaminophen

- ‍NSAIDs

- ‍Anticoagulants

- Physical therapy

- Compression stockings

- Referral to orthopedic surgeon

- Referral to rheumatologist

- Referral to vascular surgeon

- Follow-up in ‍ ‍weeksmonths

- Return if pain worsens, if new symptoms develop such as swelling or redness, or if symptoms do not improve with treatment