Leg pain
COVID-19 clinical presentation
<div class="redbox">
<p style="text-size:12px;">COVID-19 can present with a myriad of symptoms so should probably be on most differential diagnosis lists during the pandemic</p>
<li><a href="https://productivemedic.com/covid-remote-assessment/" target="_blank">COVID assessment, DDx and complications</a></li>
<li><a href="https://www.google.com/imgres?imgurl=https%3A%2F%2Ff6publishing.blob.core.windows.net%2F2ab0884c-0618-4586-aaf1-41004e6ad656%2FWJCC-8-3956-g002.png&imgrefurl=https%3A%2F%2Fwww.wjgnet.com%2F2307-8960%2Ffull%2Fv8%2Fi18%2F3956.htm&tbnid=I0G0VvXcx_akPM&vet=12ahUKEwj1_43FsrnuAhUH-YUKHSoZAFQQMygYegUIARCwAQ..i&docid=IBDQMbzRItpvKM&w=3307&h=2168&q=covid%2019%20presentation&safe=strict&ved=2ahUKEwj1_43FsrnuAhUH-YUKHSoZAFQQMygYegUIARCwAQ" target="_blank">Clinical presentation summary infographic</a></li>
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*Common causes
*Must not miss!
- Bone fracture
- Spinal cord compression
- Vascular
- DVT
- Acute limb ischaemia
<div style="text-align:center;"> <a href="https://www.bmj.com/content/360/bmj.j5842" target="_blank">Peripheral artery disease</a><br> <a href="https://www.bmj.com/content/bmj/suppl/2018/02/01/bmj.j5842.DC1/morr041877.wi.pdf" target="_blank">BMJ infographic</a> </div> - Intermittent claudication
- DVT
- Compartment syndrome
- Infections
- Malignancy
- Rhabdomyolysis
*Easily missed
- Medication (e.g. Statins)
- Polymyalgia rheumatica
- Vitamin D deficiency
- Ruptured Baker's cyst
- Spinal stenosis
- Peripheral neuropathy
Red flags
- Bilateral leg pain and/or bowel/bladder dysfunction
- Cold pulseless leg
- Hot/painful/swollen joint with little movement
- Unilateral calf pain, swelling and tenderness
- Risk factors for DVT
- Swelling of the entire leg
- Severe progressive pain
- Systemic symptoms (fever, weight loss)
- Immunosuppression
Investigations to consider
- FBC, CRP/ESR, D-dimers
- U&Es, LFTs, Blood glucose,
- Serum uric acid, bone profile, CK, Vitamin D
- Local X-ray
- Duplex USS
- Venography
- Angiography
- Nerve conduction studies
- MRI scan