Leg Pain: Or something else? Differential Diagnosis

Endocrine, nutritional, and metabolic diseases (E00-E90).

  • Hypocalcemia (calcium deficiency).
  • Hypomagnesemia (magnesium deficiency)

Cardiovascular system (I00-I99)

  • Arterial embolism – occlusion of a blood vessel; the embolus originates in the heart or large arteries and causes leg swelling by occluding a leg artery
  • Arterial thrombosis – formation of a blood clot (thrombus) in an artery.
  • Chronic venous insufficiency (CVI) – disorder of venous return; clinical picture:
    • Edema (swelling) of the legs (68%).
    • Feeling of heavy legs (tired legs), especially after long periods of sitting and standing [no certain relationship to severity of disease].
    • Painful legs, especially after long periods of sitting and standing.
    • Atrophic skin changes
  • Ischemia (reduced blood flow) in the arteries.
    • Pain
    • Hypoxic toxic edema
    • Toes and the front part of the foot are pasty and swollen
  • Peripheral arterial occlusive disease (pAVD) – progressive stenosis (narrowing) or occlusion (closure) of the arteries supplying the arms / (more often) legs, usually due to atherosclerosis (arteriosclerosis, hardening of the arteries).
  • Phlegmasia coerulea dolens – acute thrombotic occlusion of all veins of a leg, which can lead to loss of the limb.
  • Postthrombotic syndrome – chronic congestion of blood returning to the heart as a result of thrombosis:
    • Feeling of heavy legs, especially after long periods of sitting and standing.
    • Aching legs, especially after long periods of sitting and standing.
    • Calf cramps, hardening
  • Thrombophlebitis – inflammation of superficial veins with secondary formation of thrombosis.
    • Violently reddened strand
    • Very painful
    • Pressure-sensitive strand in the course of the vein
  • Deep vein thrombosis of the leg (TBVT)
    • Acute onset
    • The degree of swelling indicates the location of the thrombosis.
    • Painful; pain due to inflammation may occur several days before the leg swelling.
    • Glossy skin
    • Overheating (Calor)
  • Varices (varicose veins)
    • Dull pain in the legs after prolonged standing
    • Feeling of pressure in the legs after standing for a long time
    • Feeling of heaviness in the legs
    • Feeling of tension in the legs
    • Slight lower leg edema (increase in circumference due to water retention).
    • By elevation improvement is achieved

Musculoskeletal system and connective tissue (M00-M99).

  • Arthritis (inflammation of the joints)
    • Reddened, overheated, strongly swollen
    • Severe pain – usually occurring abruptly
  • Osteoarthritis – typical symptoms or complaints:
    • Initial pain (start-up and run-in pain common in osteoarthritis of the knee) [typical of osteoarthritis is: no discomfort at rest].
    • Joint stiffness
    • Pain on exertion
  • Activated osteoarthritis (inflammatory episode of degenerative joint disease).
    • Acute onset
  • Baker’s cyst (popliteal: belonging to the popliteal fossa); popliteal cyst) – cysts usually become symptomatic only between the 20th and 40th year of life; but can also be observed already in the 1st decade of life; symptomatology: feeling of pressure in the area of the popliteal fossa with occasional radiation into the calf.
    • Acute occurrence due to ruptured synonvial cyst (joint cyst).
  • Sciatica – pain conditions in the supply area of the sciatic nerve.
  • Lumboischialgia – low back pain in the lumbar spine, which radiate from there into the upper and lower leg.
  • Muscle injuries
    • Muscle fiber tear with hemorrhage/hematoma (bruise).
    • Muscle contusion (muscle bruise)
    • Muscle contusion
    • Muscle tear
    • Muscle strain
  • Myalgia (muscle pain)
  • Rheumatoid arthritis – chronic inflammatory multisystem disease that usually manifests itself in the form of synovitis (inflammation of the synovial membrane). It is also called primary chronic polyarthritis (PcP).

Psyche – Nervous System (F00-F99; G00-G99).

  • Neuralgia – pain may occur in the area of spread of a sensitive nerve without a demonstrable cause.
  • Nerve root irritation syndrome
  • Neuropathies (diseases of the peripheral nervous system) – diabetic, alcoholic.
  • Polyneuropathies – generic term for diseases of the peripheral nervous system associated with chronic disorders of peripheral nerves or parts of nerves; about 50% of all polyneuropathies are accompanied by pain.
  • Radiculitis (inflammation of the nerve root).

Injuries, poisonings, and other consequences of external causes (S00-T98).

  • Injuries to the knee and ankle joints
  • Injuries to ligaments or the joint capsule

Further

  • Too tight bandages

Medications that can cause edema (swelling) of the legs:

* Thrombosis/embolism caused by drugs.