What is the differential diagnosis for a 56-year-old male with a left medial malleolus fracture and proximal fibula fracture, presenting with calf tenderness but no swelling after a fall?

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Differential Diagnosis for 56-year-old male with left medial malleolus fracture and proximal fibula fracture

  • Single most likely diagnosis
    • Compartment syndrome: This is the most likely diagnosis given the patient's symptoms of calf pain and tenderness without swelling after a fracture. Compartment syndrome is a serious condition that occurs when pressure within the muscle compartments increases, leading to inadequate blood supply to the muscles and nerves.
  • Other Likely diagnoses
    • Deep vein thrombosis (DVT): The patient's recent trauma and immobilization increase the risk of developing DVT, which can cause calf pain and tenderness.
    • Muscle strain or contusion: The patient's mechanism of injury could have caused a muscle strain or contusion, leading to pain and tenderness in the calf.
    • Fat embolism: Although less common, fat embolism is a possible complication of long bone fractures, which could cause calf pain and tenderness.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Pulmonary embolism: Although the patient's symptoms are localized to the calf, it is essential to consider pulmonary embolism as a potential cause of sudden onset of pain, especially if the patient has risk factors such as recent trauma or immobilization.
    • Arterial injury: The patient's fracture could have caused an arterial injury, leading to inadequate blood supply to the affected limb.
  • Rare diagnoses
    • Rhabdomyolysis: This is a rare but potentially life-threatening condition that occurs when muscle tissue breaks down, releasing myoglobin into the bloodstream.
    • Osteomyelitis: Although unlikely in the acute setting, osteomyelitis is a possible complication of fractures, especially if the patient has underlying medical conditions or immunocompromised status.
    • Nerve injury: The patient's fracture could have caused a nerve injury, leading to pain, numbness, or tingling in the affected limb.

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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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