Differential Diagnosis for Sudden Pain and Swelling in the Leg and Foot
- Single most likely diagnosis:
- Deep Vein Thrombosis (DVT): The patient's history of a recent Pulmonary Embolism (PE) and ongoing swelling in the right foot, despite anticoagulation with Eloquist (likely a misspelling of Eliquis, an anticoagulant), suggests a possible DVT. The sharp pain in the right flank could be related to the DVT or a separate issue, but the swelling and pain in the foot are highly suggestive of a DVT.
- Other Likely diagnoses:
- Cellulitis: The swelling and pain in the foot could be due to an infection such as cellulitis, especially if the patient has a compromised immune system or an open wound.
- Musculoskeletal injury: The patient's initial complaint of sudden pain in the legs and subsequent pain in the foot could be related to a musculoskeletal injury, such as a strain or sprain.
- Nephrotic syndrome: The patient's flank pain and swelling in the foot could be related to nephrotic syndrome, a condition characterized by excessive protein loss in the urine, leading to edema.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed):
- Compartment syndrome: A condition where increased pressure within a muscle compartment leads to nerve and muscle damage. It is a medical emergency that requires prompt treatment.
- Aortic dissection: Although less likely, the patient's flank pain and history of PE could be related to an aortic dissection, which is a life-threatening condition.
- Septic thrombophlebitis: A condition where a blood clot becomes infected, leading to sepsis. It is a rare but potentially deadly condition that requires prompt treatment.
- Rare diagnoses:
- Lymphoma: The patient's swelling in the foot and flank pain could be related to a lymphoma, although this is a less likely diagnosis.
- Vasculitis: A condition where the blood vessels become inflamed, leading to damage and potentially life-threatening complications.
- Thromboangiitis obliterans (Buerger's disease): A rare condition where the blood vessels become inflamed and blocked, leading to pain and swelling in the affected limb.