Differential Diagnosis
The patient presents with multiple concerns, including a leg injury, anxiety, and restless leg symptoms. The following differential diagnosis is organized into categories:
- Single Most Likely Diagnosis
- Restless Leg Syndrome (RLS): The patient's description of "tingly" and "funny" sensations in legs, making it difficult to sit still, is consistent with RLS. The symptoms occur at home and in social situations, and the patient also reports pins and needles sensations in feet.
- Other Likely Diagnoses
- Anxiety Disorder: The patient reports ongoing significant anxiety, particularly before work and in social situations, which has led to leaving a previous job. Physical symptoms like sweating hands and rapid heartbeat in social settings support this diagnosis.
- Substance-Induced Anxiety: The patient's use of marijuana and occasional alcohol consumption may be contributing to their anxiety symptoms.
- Adjustment Disorder: The patient is about to start a new job, which may be causing stress and anxiety.
- Do Not Miss Diagnoses
- Peripheral Neuropathy: The patient's symptoms of tingling and numbness in feet could be indicative of peripheral neuropathy, which can be caused by various factors, including diabetes, vitamin deficiencies, or certain medications.
- Deep Vein Thrombosis (DVT): Although the patient's leg injury is minor, it is essential to consider DVT, especially given the patient's symptoms of leg discomfort and restlessness.
- Medication-Induced Akathisia: The patient's use of buspirone, which can cause edginess or anger, may be contributing to their restless leg symptoms.
- Rare Diagnoses
- Akathisia: A rare movement disorder characterized by a feeling of inner restlessness and a compelling need to be in constant motion.
- Complex Regional Pain Syndrome (CRPS): A rare condition characterized by chronic pain, inflammation, and sensitivity in one limb, which could be related to the patient's leg injury.
- Neurodegenerative Disorders (e.g., Parkinson's disease): Although unlikely, it is essential to consider neurodegenerative disorders, given the patient's symptoms of restlessness and tingling sensations in legs and feet.