SCAPE Diagnosis Differential
The SCAPE diagnosis is a mnemonic used to remember the differential diagnosis for a patient presenting with a swollen, painful leg. It stands for Superficial thrombophlebitis, Cellulitis, Arterial occlusion, Pulmonary embolism, and Edema (or Erythema).
- Single most likely diagnosis:
- Deep Vein Thrombosis (DVT) - This is often the most common and likely diagnosis for a patient presenting with a swollen, painful leg, especially if there are risk factors such as recent surgery, immobility, or cancer.
- Other Likely diagnoses:
- Cellulitis - An infection of the skin and subcutaneous tissues, which can cause redness, swelling, and pain in the affected leg.
- Edema - Swelling caused by fluid accumulation in the tissues, which can be due to a variety of reasons including heart failure, kidney disease, or liver disease.
- Superficial thrombophlebitis - Inflammation of a superficial vein, which can cause pain, swelling, and redness along the path of the vein.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
- Pulmonary embolism (PE) - A life-threatening condition where a blood clot breaks loose and travels to the lungs, which can be a complication of DVT.
- Arterial occlusion - A blockage of an artery, which can cause severe pain, pallor, pulselessness, poikilothermia, and paralysis of the affected limb.
- Rare diagnoses:
- Phlegmasia cerulea dolens - A rare condition caused by a massive DVT, which can lead to severe swelling, pain, and cyanosis of the affected limb.
- Lymphedema - A chronic condition characterized by swelling of the limb due to impaired lymphatic drainage, which can be primary or secondary to surgery, infection, or trauma.