Differential Diagnosis for Left Lower Extremity Pain
Single Most Likely Diagnosis
- Muscle Strain: The patient's symptoms of pain in the left calf, hamstring area, and exacerbation with activities such as walking, stairs, and playing basketball suggest a muscle strain. The fact that the pain worsened after playing basketball and is exacerbated by walking and stairs further supports this diagnosis.
Other Likely Diagnoses
- Shin Splints (Medial Tibial Stress Syndrome): Pain in the front of the calf and under the knee when descending stairs, along with tension in the upper left calf next to the bone, could indicate shin splints, a common condition in athletes.
- Tendinitis: The location of pain and the exacerbation with activities like walking on toes could also suggest tendinitis, particularly in the Achilles or peroneal tendons.
- Overuse Injury: Given the recent increase in activity (playing basketball), an overuse injury to the muscles or tendons in the lower extremity is also a plausible diagnosis.
Do Not Miss Diagnoses
- Deep Vein Thrombosis (DVT): Although less likely, DVT is a critical diagnosis that must be considered, especially if there's a history of recent immobilization, cancer, or other hypercoagulable states. The presence of calf pain and swelling could be indicative of DVT.
- Compartment Syndrome: This is a medical emergency that could present with pain, especially on exertion, and should be considered if the pain is severe and out of proportion to the expected injury.
- Stress Fracture: While less common, a stress fracture could present with pain that worsens with activity, and given the patient's recent increase in physical activity, it should not be overlooked.
Rare Diagnoses
- Peripheral Artery Disease (PAD): Although rare in younger individuals, PAD could present with exertional leg pain (claudication) that improves with rest.
- Neurogenic Claudication: This condition, often associated with spinal stenosis, could cause pain in the legs and buttocks that worsens with walking and improves with bending forward or sitting.
- Osteomyelitis or Septic Arthritis: Infection in the bone or joint could present with pain, redness, and swelling, and although rare, should be considered, especially if there are systemic symptoms like fever.