Differential Diagnosis for Loss of Sensation in Left Shin after Multiple Falls

• Single most likely diagnosis:
  • Peripheral neuropathy: This is the most likely diagnosis given the history of multiple falls and subsequent loss of sensation in the left shin. The trauma from the falls could have caused damage to the peripheral nerves, leading to neuropathy.
• Other Likely diagnoses:
  • Complex regional pain syndrome (CRPS): This condition can occur after trauma, such as falls, and is characterized by chronic pain, sensitivity, and changes in skin temperature and color. The loss of sensation in the left shin could be a symptom of CRPS.
  • Radiculopathy: Nerve root damage or compression in the lumbar spine could cause loss of sensation in the left shin. The multiple falls could have caused or exacerbated this condition.
  • Neuroma: A neuroma is a growth of nerve tissue that can occur after nerve damage, such as that caused by the falls. It could be pressing on nearby nerves, causing the loss of sensation.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
  • Cauda equina syndrome: This is a serious condition that occurs when the nerves in the lumbar spine are compressed, causing loss of sensation, weakness, and potentially permanent damage. Although less likely, it is crucial to rule out this condition due to its severe consequences.
  • Spinal cord injury: A spinal cord injury could have occurred during one of the falls, causing the loss of sensation in the left shin. This condition requires immediate medical attention to prevent further damage.
  • Deep vein thrombosis (DVT): Although less directly related to the loss of sensation, DVT is a potential complication of immobility after falls and could lead to pulmonary embolism if not addressed.
• Rare diagnoses:
  • Sjögren's syndrome: This autoimmune disorder can cause peripheral neuropathy, but it is less common and would typically be associated with other symptoms such as dry eyes and mouth.
  • Vitamin deficiency (e.g., vitamin B12 deficiency): Certain vitamin deficiencies can cause peripheral neuropathy, but this would be an unusual cause of localized loss of sensation in the left shin without other symptoms.