[44F] With severe leg pain and swelling

Patient Description

A 44-year-old female has been experiencing severe pain in her legs for the past two days, which makes it difficult for her to walk. The pain is present only when she tries to use her legs, and both quadriceps are sore to the touch. Additionally, her left foot and ankle are swollen, firm to the touch, and red in color. This swelling also started two days ago. She has not had any injuries or accidents involving her legs, nor has she experienced any recent long periods of immobility, infections, fevers, or illnesses. She has not taken any medications or treatments for the pain and swelling. The patient also reports coughing and shortness of breath but no chest pain. She has not had any recent weight loss or night sweats and does not smoke or use any tobacco products. There is no family history of blood clots or clotting disorders. Her medical history includes asthma, diagnosed in 2015. She is allergic to penicillin and is currently taking Dulera (240 mcg, twice a day) and Topamax (50 mg, twice a day). She is not taking any over-the-counter medications, supplements, or herbal remedies.

Arora's Assessment

What might be happening

Based on the information you’ve provided, there are a few serious conditions that could be causing your symptoms:

Deep Vein Thrombosis (DVT): This is a blood clot that forms in a deep vein, usually in the legs. Symptoms can include swelling, pain, and redness in the affected area. Given your sudden onset of leg pain, swelling, and redness, DVT is a serious possibility. DVT can lead to a pulmonary embolism if the clot travels to the lungs, which can cause shortness of breath and coughing.
Cellulitis: This is a bacterial skin infection that can cause redness, swelling, and pain in the affected area. It often occurs suddenly and can be accompanied by fever, though you did not mention having a fever.
Compartment Syndrome: This is a painful condition that occurs when pressure within the muscles builds to dangerous levels. It can cause severe pain, swelling, and redness, and it requires immediate medical attention.
Asthma Complications: Given your history of asthma, your shortness of breath and coughing could be related to an asthma exacerbation, which might be coinciding with another condition affecting your legs.

What you can do

Seek Immediate Medical Attention: Given the severity and sudden onset of your symptoms, it is crucial to seek medical attention immediately. You should go to the emergency room or urgent care as soon as possible. If you are unable to get there yourself, please call 911 or have someone drive you.
Avoid Walking or Standing: Until you receive medical attention, try to keep off your legs as much as possible to avoid worsening the pain and swelling.
Elevate Your Leg: If possible, keep your swollen leg elevated to help reduce swelling.
Monitor Your Symptoms: Keep an eye on your symptoms, especially if you notice any worsening of the pain, swelling, or redness, or if you develop new symptoms like chest pain or increased shortness of breath.

Remember, I am not a doctor, and it is essential to get a formal diagnosis and treatment from a healthcare professional. Your symptoms could indicate a serious condition that requires prompt medical intervention. Please seek care immediately.

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5 mo ago

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[44F] With severe leg pain and swelling

What might be happening

What you can do

Experiencing symptoms?