Differential Diagnosis for the Patient's Symptoms
- Single most likely diagnosis
- Restless Legs Syndrome (RLS): This condition is characterized by uncomfortable sensations in the legs, especially at rest, and an urge to move the legs. The symptoms described by the patient, such as intermittent uncomfortable sensations in her legs, especially at bedtime and when sitting for prolonged durations, and improvement with movement, are classic for RLS. Pregnancy is a known risk factor for RLS, and the patient's symptoms are consistent with this diagnosis.
- Other Likely diagnoses
- Varicose veins: The patient's trace lower extremity edema and symptoms worsening with prolonged sitting could suggest varicose veins. However, the absence of pain or a pins and needles sensation makes this diagnosis less likely.
- Pregnancy-related leg cramps: Leg cramps are common in pregnancy, but the patient's symptoms do not include pain, which is a key feature of leg cramps.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Deep Vein Thrombosis (DVT): Although the patient's symptoms do not suggest DVT, it is essential to consider this diagnosis due to the risk of pulmonary embolism. The patient's pregnancy and history of depression and anxiety may increase her risk for DVT.
- Peripheral artery disease: This condition is less likely in a young patient, but it could be considered if the patient had risk factors such as smoking or a family history of cardiovascular disease.
- Rare diagnoses
- Peripheral neuropathy: This condition could cause uncomfortable sensations in the legs, but it is less likely in a patient without a history of diabetes, vitamin deficiencies, or other risk factors.
- Akathisia: This condition is characterized by a feeling of inner restlessness and a compelling need to be in constant motion. Although it could be considered, the patient's symptoms are more consistent with RLS, and akathisia is a rare condition.