Differential Diagnosis for Leg Mass with Mental Status Change
- Single most likely diagnosis
- Deep Vein Thrombosis (DVT) with Pulmonary Embolism (PE): This is a common and life-threatening condition where a blood clot forms in the deep veins of the leg and breaks loose, traveling to the lungs, which can cause mental status changes due to hypoxia or decreased cardiac output.
- Other Likely diagnoses
- Cellulitis or Abscess: A severe infection of the skin and soft tissues can cause a leg mass and, if systemic, can lead to mental status changes due to sepsis.
- Osteomyelitis: An infection of the bone can cause a mass and systemic symptoms, including changes in mental status if the infection becomes severe or spreads.
- Soft Tissue Sarcoma: Although less common, a growing tumor in the leg could cause a mass, and if metastatic, could lead to mental status changes.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Necrotizing Fasciitis: A severe, life-threatening infection that can cause a leg mass and rapidly progress to sepsis and multi-organ failure, including mental status changes.
- Gas Gangrene: An infection with Clostridium perfringens that can cause a leg mass and rapidly lead to sepsis, shock, and death if not promptly treated.
- Compartment Syndrome: Increased pressure within a muscle compartment can cause a leg mass and, if severe, can lead to decreased blood flow to the brain, causing mental status changes.
- Rare diagnoses
- Eosinophilic Fasciitis: A rare condition characterized by inflammation of the skin and soft tissues, which can cause a leg mass and, in severe cases, systemic symptoms including mental status changes.
- Lymphoma: A type of cancer that can cause a leg mass and, if systemic, can lead to mental status changes due to metastasis or paraneoplastic syndromes.
- Neurofibromatosis: A genetic disorder that can cause tumors to form on nerve tissue, potentially leading to a leg mass, and in rare cases, mental status changes due to CNS involvement.