Differential Diagnosis for Calf Pain and Inability to Bear Weight in Pregnancy

• Single Most Likely Diagnosis

  • Deep Vein Thrombosis (DVT): This is a common concern in pregnancy due to increased blood clotting propensity. Calf pain and swelling, especially if unilateral, along with an inability to bear weight, could indicate a DVT. The risk factors associated with pregnancy, such as venous stasis and hypercoagulability, make DVT a leading consideration.

• Other Likely Diagnoses

  • Muscle Strain: Overexertion or minor trauma can lead to muscle strain, which is common in pregnancy due to altered gait and increased weight. This could cause calf pain and difficulty walking.
  • Varicose Veins: While not typically causing acute pain, severe varicose veins can lead to discomfort and swelling, potentially causing difficulty bearing weight.
  • Peripheral Edema: Common in pregnancy, peripheral edema can sometimes cause discomfort or pain, especially if severe.

• Do Not Miss Diagnoses

  • Pulmonary Embolism (PE): Although it might not directly cause calf pain, a PE can lead to sudden onset of symptoms that might indirectly cause an inability to bear weight due to shortness of breath or chest pain. It's crucial to consider PE in the differential due to its high mortality rate if missed.
  • Compartment Syndrome: This is a medical emergency that can cause severe pain, especially on palpation, and an inability to bear weight. It's less common but critical not to miss due to the potential for long-term damage.
  • Osteonecrosis: Though less common, osteonecrosis (avascular necrosis) of the bones around the ankle or lower leg could cause severe pain and an inability to bear weight. This condition can be associated with long-term corticosteroid use, which might be relevant in some pregnancy complications.

• Rare Diagnoses

  • Popliteal Artery Aneurysm or Thrombosis: These vascular issues can cause acute limb ischemia, leading to severe pain and an inability to bear weight. They are rare but require immediate medical attention.
  • Neurological Conditions: Such as peripheral neuropathy or radiculopathy, which could cause pain and weakness in the calf, leading to an inability to bear weight. These are less common causes of acute calf pain in pregnancy.