Differential Diagnosis

• Single most likely diagnosis
  • Peripheral arterial disease (PAD): Given the patient's history of hyperlipidemia, essential hypertension, and uncontrolled type 2 diabetes mellitus, PAD is the most plausible cause for leg pain, especially if the pain is exacerbated by walking (claudication). The combination of these risk factors significantly increases the likelihood of PAD.
• Other Likely diagnoses
  • Deep vein thrombosis (DVT): The elevated D-dimer level raises concern for DVT, especially in the context of leg pain. Although D-dimer can be elevated in many conditions, it warrants further investigation for DVT.
  • Statin-induced myopathy: The patient's complaint of sharp pains around the chest area attributed to Rosuvastatin suggests the possibility of statin-induced myopathy, which could also contribute to leg pain if the muscles in the legs are affected.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
  • Aortic dissection: Although less likely, given the patient's history of hypertension, aortic dissection is a potentially life-threatening condition that could cause leg pain and must be considered.
  • Pulmonary embolism: If DVT is suspected, pulmonary embolism (PE) must also be considered, as it is a potentially fatal complication of DVT.
• Rare diagnoses
  • Vasculitis: Conditions like giant cell arteritis or polyarteritis nodosa could cause leg pain but are less common and would require specific diagnostic criteria to be met.
  • Peripheral neuropathy: While more commonly associated with diabetes, other causes of peripheral neuropathy (e.g., vitamin deficiencies) could also lead to leg pain, though they are less likely given the patient's presentation.