What is the cause of leg pain (lower extremity pain)?

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Last updated: April 20, 2025View editorial policy

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Differential Diagnosis for Pain to Leg

  • Single most likely diagnosis
    • Musculoskeletal strain: This is the most common cause of leg pain, often resulting from overuse, injury, or poor posture. Justification: High prevalence and common presentation in clinical practice.
  • Other Likely diagnoses
    • Osteoarthritis: Wear and tear of the joints can cause pain in the legs, especially in older adults. Justification: Common condition, especially in older populations.
    • Peripheral artery disease (PAD): Reduced blood flow to the legs can cause pain, especially during walking. Justification: Common in smokers and those with cardiovascular risk factors.
    • Nerve compression or neuropathy: Conditions like sciatica or peripheral neuropathy can cause leg pain. Justification: Common causes of leg pain, especially in patients with diabetes or those who have experienced trauma.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Deep vein thrombosis (DVT): A blood clot in the deep veins of the leg can cause pain and swelling, and can be life-threatening if it breaks loose and travels to the lungs. Justification: Potentially life-threatening condition that requires prompt diagnosis and treatment.
    • Compartment syndrome: Increased pressure within the muscle compartments can cause severe pain and permanent damage if not treated promptly. Justification: Emergency condition that can result in significant morbidity if missed.
    • Osteomyelitis or septic arthritis: Infections of the bone or joint can cause severe leg pain and require urgent treatment. Justification: Potentially life-threatening conditions that require prompt diagnosis and treatment.
  • Rare diagnoses
    • Erythromelalgia: A rare condition characterized by burning pain, heat, and redness in the legs. Justification: Uncommon condition, but should be considered in patients with characteristic symptoms.
    • Complex regional pain syndrome (CRPS): A rare condition characterized by chronic pain, inflammation, and sensitivity in the legs. Justification: Uncommon condition, but can be debilitating if not recognized and treated.
    • Legg-Calve-Perthes disease: A rare condition characterized by avascular necrosis of the femoral head, causing hip and leg pain. Justification: Uncommon condition, primarily affecting children, but should be considered in patients with characteristic symptoms.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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