Differential Diagnosis for Bilateral Leg Pain
Single Most Likely Diagnosis
- Peripheral Artery Disease (PAD): This condition is a common cause of bilateral leg pain, especially in older adults with a history of smoking or diabetes. The pain is typically intermittent and worsens with walking or exercise.
Other Likely Diagnoses
- Musculoskeletal Strain: Overuse or repetitive strain on the muscles and tendons in the legs can cause bilateral pain, often seen in athletes or individuals with physically demanding jobs.
- Varicose Veins: Enlarged or twisted veins can cause pain, swelling, and discomfort in both legs, particularly after standing or walking for long periods.
- Diabetic Neuropathy: High blood sugar levels can damage the nerves in the legs, leading to bilateral pain, numbness, or tingling sensations.
- Osteoarthritis: Wear and tear on the joints in the legs can cause bilateral pain, stiffness, and limited mobility, especially in older adults.
Do Not Miss Diagnoses
- Deep Vein Thrombosis (DVT): A blood clot in the deep veins of the legs can cause severe pain, swelling, and warmth, and can be life-threatening if it breaks loose and travels to the lungs.
- Aortic Aneurysm: A weakened or bulging aorta can cause abdominal and back pain that radiates to the legs, and can be fatal if it ruptures.
- Spinal Stenosis: Narrowing of the spinal canal can cause compression of the nerves, leading to bilateral leg pain, numbness, or weakness.
- Infection (e.g., Osteomyelitis or Cellulitis): Bacterial or fungal infections can cause severe pain, swelling, and redness in the legs, and can be life-threatening if left untreated.
Rare Diagnoses
- Ehlers-Danlos Syndrome: A genetic disorder that affects the connective tissue, causing joint hypermobility, skin hyperextensibility, and tissue fragility, which can lead to bilateral leg pain.
- Fabry Disease: A rare genetic disorder that causes the buildup of a particular type of fat in the body, leading to pain, numbness, and tingling sensations in the legs.
- Chronic Regional Pain Syndrome (CRPS): A condition characterized by chronic pain, inflammation, and sensitivity in one or both legs, often after an injury or trauma.
- Sickle Cell Disease: A genetic disorder that affects the production of hemoglobin, causing red blood cells to become misshapen and break down, leading to episodes of pain, including bilateral leg pain.