Differential Diagnosis for Pain and Swelling in the Lower Leg 12 Days Post Total Knee Arthroplasty
Single Most Likely Diagnosis
- Deep Vein Thrombosis (DVT): This is a common complication following major orthopedic surgeries like total knee arthroplasty, especially given the symptoms of pain and swelling in the lower leg. The recent surgery and immobilization increase the risk of DVT.
Other Likely Diagnoses
- Infection (e.g., cellulitis or wound infection): Post-surgical infections can present with pain, swelling, and redness at the surgical site. The ongoing nausea and vomiting could be related to infection or antibiotic use.
- Hematoma or Seroma: Accumulation of blood or fluid at the surgical site can cause swelling and pain. This could be a complication of the surgery itself.
- Nerve Injury or Neuropathic Pain: Direct injury to nerves during surgery or compression from swelling could lead to pain in the lower leg.
Do Not Miss Diagnoses
- Pulmonary Embolism (PE): Although less likely than DVT, PE is a potentially life-threatening condition that can occur if a DVT dislodges and travels to the lungs. The symptoms of nausea and vomiting could be non-specific presentations of PE.
- Septic Arthritis or Osteomyelitis: Infection within the joint or bone can have severe consequences if not promptly treated. These conditions require urgent diagnosis and management.
- Compartment Syndrome: This is a serious condition resulting from increased pressure within a muscle compartment, which can lead to muscle and nerve damage. It is less common but critical to diagnose early.
Rare Diagnoses
- Rhabdomyolysis: Although rare, this condition involves the breakdown of muscle tissue and can be triggered by various factors, including surgery, immobilization, and certain medications.
- Arterial Thrombosis or Embolism: These are less common than venous thrombosis but can lead to severe ischemia of the limb, requiring immediate intervention.