Differential Diagnosis for a 30-year-old Lady with Burning Sensation over Feet and Pedal Edema

Single Most Likely Diagnosis

• Thyroid Disorders: Hypothyroidism can cause peripheral neuropathy leading to burning sensations in the feet, and it can also cause pedal edema due to fluid retention. Given the age and symptoms of the patient, and the absence of diabetes, thyroid disorders are a plausible cause.

Other Likely Diagnoses

• Vitamin B12 Deficiency: This condition can lead to peripheral neuropathy, causing burning sensations in the feet. While less common than thyroid disorders, it's a possible cause, especially if the patient has a history of dietary deficiencies or malabsorption.
• Idiopathic Edema: Some women experience cyclic edema that can be associated with hormonal changes, which might also explain the pedal edema. However, the burning sensation would need another explanation, possibly related to a separate condition or a secondary effect of the edema.
• Anxiety or Stress: Sometimes, anxiety or stress can manifest as physical symptoms, including burning sensations in the feet, though this would be less likely to cause significant pedal edema.

Do Not Miss Diagnoses

• Deep Vein Thrombosis (DVT): Although less likely given the description, DVT can cause swelling and pain in the legs, which might be perceived as a burning sensation. Missing this diagnosis could be fatal due to the risk of pulmonary embolism.
• Lymphoma or Other Malignancies: Certain cancers can cause neuropathy and edema. While rare, these conditions are critical not to miss due to their severe prognosis if left untreated.
• Infections (e.g., Cellulitis): Infections can cause swelling, redness, and pain, which might be described as a burning sensation. Antibiotic treatment is essential for these conditions, making prompt diagnosis crucial.

Rare Diagnoses

• Erythromelalgia: A rare disorder characterized by burning pain, heat, and redness in the hands and feet. It could be primary (idiopathic) or secondary to another condition like myeloproliferative disorders.
• Fabry Disease: An inherited disorder that can cause burning sensations in the feet due to peripheral neuropathy. It's rare and typically presents with other systemic symptoms.
• Sarcoidosis: A condition that can cause neuropathy and might lead to edema in rare cases, though it's more commonly associated with lung and skin manifestations.