Differential Diagnosis

The patient's symptoms of pain when walking, left leg swelling, and a burning sensation on the abdomen where a wound was previously healed can be approached by considering the following categories:

• Single Most Likely Diagnosis
  • Deep Vein Thrombosis (DVT): This is a likely diagnosis given the patient's complaint of pain when walking and swelling in one leg. The burning sensation on the abdomen could be unrelated, but the combination of leg symptoms points towards DVT.
• Other Likely Diagnoses
  • Cellulitis or Infection: Although the wound on the abdomen is healed, the burning sensation could indicate an underlying infection or cellulitis, especially if the wound was not properly cared for. The leg swelling could be due to a different cause, such as heart failure or kidney disease, but in the context of pain when walking, it's less likely.
  • Peripheral Artery Disease (PAD): This condition could cause pain when walking due to inadequate blood flow to the muscles. However, it typically presents with intermittent claudication (pain in the legs or arms that occurs during exercise and is relieved by rest) and might not fully explain the swelling or the abdominal burning sensation.
• Do Not Miss Diagnoses
  • Pulmonary Embolism (PE): If the patient has DVT, there's a risk of the clot breaking loose and traveling to the lungs, causing a potentially fatal PE. Although the primary symptoms don't directly suggest PE, any suspicion of DVT warrants consideration of this risk.
  • Abdominal Wall Hernia or Complication: The burning sensation where the wound was could indicate a complication such as a hernia, especially if the wound was a result of surgery. This could lead to bowel obstruction or strangulation, which are medical emergencies.
• Rare Diagnoses
  • Erythromelalgia: A rare disorder characterized by burning pain, heat, and redness in the hands and feet, which could potentially explain the burning sensation and pain when walking, though it's less likely given the swelling and the specific location of the burning sensation.
  • Complex Regional Pain Syndrome (CRPS): This is a rare condition that can cause severe, burning pain, usually in an arm or leg, after an injury or trauma. The symptoms could fit, but CRPS is relatively rare and would not directly explain the swelling unless it was part of a broader syndrome including edema.

Each of these diagnoses requires careful consideration of the patient's full medical history, physical examination, and potentially, diagnostic tests to determine the underlying cause of their symptoms.