Differential Diagnosis I
“Deep Vein Thrombosis Treatment Portland: DVT Bend.” (Inovia Vein Specialty Centers)
Deep Vein Thrombosis (DVT)
A deep vein thrombosis (DVT) is the manifestation of a blood clot in the lower extremities, typically the leg or thigh. A DVT is a serious condition due to the fact that the clot can easily loosen and travel to the lungs where it becomes lodged; causing a pulmonary embolism which is a life-threatening emergency. DVTs have similar signs and symptoms to peripheral artery disease (PAD) which is why they can be easily mistaken for each other. Both PAD and DVTs cause lower leg pain, however there are differences in the leg pain which are important to know.
PAD leg pain typically occurs when walking or exercising and can improve with rest, whereas with DVTs the pain occurs at rest and is improved with elevation. Another important differentiating factor is the how the lower extremity looks and feels. DVTs have noticeable swelling where the clot has formed, and the skin is red and hot to the touch. In a patient with PAD, there is no swelling and the skin is cool to the touch due to the decreased blood flow. Both conditions center around leg pain, however, understanding those differences can help identify and diagnose peripheral artery disease.
Differential Diagnosis II
“Heart Problems Linked to Total Joint Replacement Surgery in Osteoarthritis.” (MD Magazine 2015)
Osteoarthritis
Osteoarthritis is a degenerative disease that often results in chronic joint pain due to the deterioration of cartilage. Cartilage is a firm tissue that provides the joint with a cushion for bones and allows for frictionless movement. However, this cartilage can breakdown and cause bone to rub on bone. Once this occurs, the patient can experience severe pain and inflammation in the joints.
Since osteoarthritis can cause leg pain while walking, it is important to know the differences between this and peripheral artery disease. In osteoarthritis the pain occurs in joints, causing stiffness and sometimes swelling. PAD pain is not specific to joints but rather a cramping sensation in the muscles. Arthritic pain can also lead to inflammation of the joints, causing them to be warm to the touch. Whereas, cool extremities and weak pulses are typical in PAD.
Differential Diagnosis III
“Diabetic Peripheral Neuropathy Explained.” WebMD
Diabetic Neuropathy
Diabetic neuropathy is a type of nerve damage that occurs in individuals diagnosed with diabetes, with damage mostly occurring in the nerves of the legs and feet. Symptoms with this condition can range anywhere from mild numbness to severe pain in the lower extremities. However, leg pain is not the only shared symptom with peripheral artery disease. Both conditions exhibit reduced blood flow to the lower extremities, weak pulses, cold feet, discoloration and prone to ulcers. Additionally, having diabetes puts you at an especially high risk for developing PAD. Due to the similarities of these conditions, it can be quite difficult to differentiate them.
The biggest symptom to take note of is the leg pain/numbness in diabetic neuropathy and intermittent claudication in PAD. In both diseases discoloration of the legs, cool extremities and weak pulses accompany the pain. These similarities make is hard to distinguish, requiring further neurological evaluation.