What is the cause of left leg pain and swelling in a patient with no history of deep vein thrombosis (DVT)?

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Differential Diagnosis for Left Leg Pain and Swelling

Single Most Likely Diagnosis

  • Muscle Strain: The most common cause of leg pain and swelling, especially if the patient has recently engaged in physical activity or has a history of overuse. The denial of deep vein thrombosis (DVT) history does not rule out other musculoskeletal issues.

Other Likely Diagnoses

  • Cellulitis: A bacterial skin infection that can cause pain, swelling, and redness in the affected leg. It's a common condition that can arise from minor skin breaks or infections.
  • Deep Vein Thrombosis (DVT): Despite the patient's denial of history, DVT cannot be completely ruled out without further investigation, as it is a significant cause of leg swelling and pain.
  • Peripheral Artery Disease (PAD): A condition where narrowed arteries reduce blood flow to the legs, causing pain, especially during walking, and swelling.

Do Not Miss Diagnoses

  • Compartment Syndrome: A serious condition resulting from increased pressure within a muscle compartment, which can lead to nerve and muscle damage. It requires immediate medical attention.
  • Septic Arthritis: An infection within a joint, which can cause severe pain and swelling. Prompt diagnosis and treatment are crucial to prevent long-term joint damage.
  • Osteomyelitis: A bone infection that can cause pain, swelling, and redness in the affected area. It's a serious condition that requires early diagnosis and treatment.

Rare Diagnoses

  • Lymphedema: A condition characterized by chronic swelling due to impaired lymphatic drainage. It's less common but should be considered if other causes are ruled out.
  • Erythromelalgia: A rare disorder that causes burning pain, heat, and redness in the hands and feet. It's an uncommon condition but could be a consideration in the differential diagnosis.
  • Neoplastic Conditions: Rarely, leg pain and swelling can be symptoms of underlying neoplastic conditions, such as soft tissue sarcomas. Although uncommon, these conditions should not be overlooked in the diagnostic process.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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