Leg Pain (cont.)
IN THIS ARTICLE
When Should People Seek Medical Care for Leg Pain?
People often decide to seek care after an injury based upon their ability to stand, bear weight, and walk. This is often reasonable; however, if there is concern that a bone is broken or there is significant swelling to a joint, medical care should be sought in an urgent manner. A swollen joint is never normal. One important reminder: Just because the leg can move does not mean that it is not injured.
In most other situations, leg pain has a gradual onset and patients seek medical attention when the pain begins to interfere with their daily lives. Often, leg pain is a part of a larger collection of symptoms and is not evaluated independently.
However, when leg pain begins suddenly, it should be a cause for concern and medical care should be sought urgently. This is especially the case if the leg is warm and swollen and deep venous thrombosis is of concern, or if the leg is pale and cool and an arterial clot is a consideration.
If back and leg pain occurs with episodes of increased muscle weakness, falling, or changes in bowel or bladder function, this may signal an emergency involving the spinal cord called cauda equina. Medical care should be accessed immediately.
Children who develop leg pain and begin to limp or who develop a fever should be seen immediately for evaluation.
How Do Health-Care Professionals Diagnose Leg Pain?
The evaluation of leg pain always begins with the health-care provider interviewing the patient and performing a physical examination to help determine the potential cause of the leg pain. The decision about diagnostic testing, including blood tests and X-rays, depends upon the provider's concern as to what the cause of the leg pain might be. Sometimes testing and X-rays are not required.
Blood tests including a white blood cell count, an erythrocyte sedimentation rate (ESR), and a C-reactive protein (CRP) measurement may help detect an infection. These are nonspecific tests that may give further direction to the health-care provider. Please note that the white blood cell count may be elevated with an infection unless the patient has an immune system that is compromised, at which point it may be falsely normal. As with all tests, the ESR and CRP, if elevated, need to be interpreted in light of the specific illness that is being considered.
If gout is a consideration, a blood test to measure uric acid may be done; however, in the acute attack, the uric acid level may be high, low, or normal. The result is helpful if the level is high and may confirm a gout flare if supported by the history and physical examination.
Other blood tests may be considered depending upon the underlying medical illnesses being considered.
Medically Reviewed by a Doctor on 9/11/2017
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