Differential Diagnosis for Martha's Right Leg Pain
- Single most likely diagnosis
- Medial Tibial Stress Syndrome (Shin Splints): This is the most likely diagnosis given Martha's history of playing soccer, the location of the pain (right shin), and the description of the pain as burning and worsening with activity such as walking, jumping, and putting pressure on the leg. The fact that she was wearing shin guards and still got injured suggests that the impact might not have been directly related to the trauma but rather to overuse or stress on the tibia.
- Other Likely diagnoses
- Contusion: Given that Martha was kicked on the right leg during soccer, a contusion (bruise) is a possible diagnosis. The pain and tenderness to touch are consistent with this, although the burning quality of the pain might be less typical.
- Stress Fracture: While less common in adolescents, stress fractures can occur, especially in athletes involved in high-impact activities. The worsening of pain with weight-bearing activities and the presence of pain at the site of impact could suggest a stress fracture.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Osteosarcoma or other bone tumors: Although rare, bone tumors can present with pain that worsens with activity. It's crucial to consider these in the differential diagnosis due to their severe implications if missed.
- Compartment Syndrome: This is a medical emergency that can result from increased pressure within a muscle compartment, leading to nerve and muscle damage. The burning pain and worsening with activity could be indicative of compartment syndrome, especially if there's significant swelling or pallor.
- Rare diagnoses
- Peripheral Nerve Injury: Direct trauma from the kick could potentially cause a peripheral nerve injury, leading to pain, numbness, or tingling in the affected area. However, the description provided does not strongly suggest nerve damage.
- Infection (Osteomyelitis or Cellulitis): Infection of the bone or soft tissue could present with pain, redness, and swelling. While possible, especially if the skin was broken during the injury, the current description does not strongly support this diagnosis without additional symptoms like fever or significant redness and swelling.