[75F] Experiencing hip, thigh, and leg pain

Right hip, thigh, leg, shin, and knee pain

Differential diagnosis

• Given the patient's age and history of falls, the most likely diagnoses are hip osteoarthritis (M16.10), hip bursitis (M70.60), or a hip fracture (S72.00).
• Other possible diagnoses include sciatica (M54.30), lumbar spinal stenosis (M48.06), or a knee condition such as osteoarthritis (M17.10) or meniscus tear (S83.2).

Plan

Perform a physical examination of the hip, thigh, leg, shin, and knee, focusing on range of motion, strength, and areas of tenderness. Order imaging studies, such as an X-ray or MRI, to evaluate for possible fractures, arthritis, or other structural abnormalities.

If the pain is due to osteoarthritis or bursitis, consider a trial of physical therapy and non-steroidal anti-inflammatory drugs (NSAIDs). If the patient has a fracture, refer to orthopedics for further management.

Given the patient's age and history of falls, consider a fall risk assessment and interventions to prevent future falls, such as physical therapy, balance exercises, and home safety modifications.

Re-evaluate the patient in 2-4 weeks to assess the effectiveness of the treatment plan and adjust as needed. If the patient's symptoms persist or worsen, consider referral to a specialist, such as a rheumatologist or orthopedic surgeon.