Differential Diagnosis for Unilateral Leg Swelling with Tenderness to the Touch, No Warmth

• Single Most Likely Diagnosis
  • Deep Vein Thrombosis (DVT): This is the most likely diagnosis due to the presentation of unilateral leg swelling and tenderness. DVT typically does not cause warmth, which aligns with the symptoms described.
• Other Likely Diagnoses
  • Cellulitis without infection: Although warmth is often associated with cellulitis, early stages or certain types might not present with increased temperature, making this a possible diagnosis.
  • Lymphedema: This condition can cause unilateral leg swelling and may be tender, especially if there's an underlying infection or injury.
  • Chronic Venous Insufficiency: This condition can lead to leg swelling and tenderness, particularly if there are varicose veins or a history of DVT.
• Do Not Miss Diagnoses
  • Pulmonary Embolism (if associated with DVT): It's crucial to consider the possibility of a pulmonary embolism, especially if the patient has risk factors or symptoms such as shortness of breath or chest pain.
  • Compartment Syndrome: Although typically associated with more severe pain and pallor, compartment syndrome is a medical emergency that requires prompt diagnosis and treatment.
  • Malignancy (e.g., lymphoma or metastasis): In rare cases, unilateral leg swelling can be a sign of an underlying malignancy, making it essential not to miss this potential diagnosis.
• Rare Diagnoses
  • Lipedema: A chronic condition characterized by the abnormal growth of fat cells in the legs, leading to swelling and tenderness.
  • Fabry Disease: A rare genetic disorder that can cause leg swelling, among other symptoms, due to the accumulation of a particular type of fat in the body's cells.
  • Klippel-Trenaunay Syndrome: A rare congenital condition that affects blood and lymph vessels, leading to swelling, varicose veins, and other symptoms in the affected limb.