Differential Diagnosis for Left Thigh Pain
Single Most Likely Diagnosis
- Lumbar Radiculopathy: Given the progression from muscle tear-like pain to burning pain, and the involvement of the right thigh and buttock, lumbar radiculopathy is a strong consideration. The patient's long history of sleeping on a sofa may have contributed to poor spinal alignment and disc issues, leading to nerve root compression. The referral to Neurology also supports this diagnosis.
Other Likely Diagnoses
- Piriformis Syndrome: The burning pain and involvement of the buttock could suggest piriformis syndrome, where the piriformis muscle compresses the sciatic nerve.
- Diabetic Neuropathy: The patient is on Ozempic, which is used to treat type 2 diabetes. An increase in Ozempic and concerns about B12 labs may indicate diabetic neuropathy, which could cause burning pain in the thighs.
- Musculoskeletal Strain: The patient's history of sleeping on a sofa and potential poor posture could lead to musculoskeletal strain, causing pain in the thighs and buttock.
Do Not Miss Diagnoses
- Cauda Equina Syndrome: Although less likely, cauda equina syndrome is a serious condition that requires prompt attention. It is characterized by low back pain, sciatica, and potentially bowel or bladder dysfunction. The patient's tailbone pain and burning sensations in the thighs could be indicative of this condition.
- Spinal Stenosis: This condition can cause pain, numbness, and weakness in the legs, and is a potential cause of the patient's symptoms.
Rare Diagnoses
- Peripheral Artery Disease: Although less common, peripheral artery disease could cause burning pain in the thighs, especially if the patient has a history of smoking or other cardiovascular risk factors.
- Inflammatory Myopathies: The patient's history of muscle biopsy and current symptoms could suggest an inflammatory myopathy, such as polymyositis or dermatomyositis, although these conditions are relatively rare.