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.
  • Peripheral Neuropathy: The patient's symptoms of tingling sensation in feet and legs could be indicative of peripheral neuropathy, possibly related to their smoking habit or other underlying conditions.
• Do Not Miss Diagnoses
  • Deep Vein Thrombosis (DVT): Although the patient's leg injury is minor, it's essential to consider DVT, especially given their smoking habit and potential for immobility.
  • Neurodegenerative Disorders (e.g., Parkinson's disease): Although less likely, the patient's symptoms of restlessness and tingling sensations could be indicative of a neurodegenerative disorder.
  • Medication-Induced Akathisia: The patient's use of buspirone, which can cause edginess or anger, may be contributing to their restlessness and anxiety symptoms.
• Rare Diagnoses
  • Akathisia: A rare condition characterized by subjective feelings of restlessness and objective signs of agitation, which could be related to the patient's medication use or underlying conditions.
  • Complex Regional Pain Syndrome (CRPS): A rare condition characterized by chronic pain, inflammation, and hypersensitivity, which could be related to the patient's leg injury.

Each diagnosis is considered based on the patient's symptoms, medical history, and social history. A thorough evaluation and additional testing may be necessary to confirm or rule out these diagnoses.