Differential Diagnosis for Bilateral Leg Pain
- Single most likely diagnosis
- Peripheral arterial disease (PAD): This is a common condition characterized by the narrowing or blockage of the blood vessels outside of the heart, leading to reduced blood flow to the legs. It is often associated with bilateral leg pain, especially during exercise.
- Other Likely diagnoses
- Venous insufficiency: This condition occurs when the veins have problems returning blood from the legs to the heart, leading to blood pooling and pain.
- Musculoskeletal strain: Overuse or injury to the muscles and tendons in the legs can cause bilateral leg pain.
- Diabetic neuropathy: High blood sugar levels can damage the nerves in the legs, leading to pain, numbness, and tingling.
- Chronic kidney disease: Mineral and bone disorders associated with chronic kidney disease can cause bilateral leg pain.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Aortic dissection: A tear in the inner layer of the aorta can cause severe, sudden-onset bilateral leg pain and is a medical emergency.
- Deep vein thrombosis (DVT): A blood clot in the deep veins of the legs can cause pain, swelling, and warmth, and can be life-threatening if it breaks loose and travels to the lungs.
- Compartment syndrome: Increased pressure within the muscle compartments of the legs can cause severe pain, numbness, and tingling, and can lead to permanent damage if not treated promptly.
- Spinal cord compression: Compression of the spinal cord can cause bilateral leg pain, numbness, and weakness, and can lead to permanent paralysis if not treated promptly.
- Rare diagnoses
- Peripheral neuropathy due to vitamin deficiency (e.g., vitamin B12 deficiency): Certain vitamin deficiencies can cause damage to the nerves in the legs, leading to pain, numbness, and tingling.
- Erythromelalgia: A rare disorder characterized by burning pain, heat, and redness in the hands and feet.
- Complex regional pain syndrome (CRPS): A chronic pain condition characterized by severe, burning pain in one or more limbs, often after an injury or trauma.