Cause Comments Fractured Femur May be atypical in elderly or those with delirium or dementia. Consider a pathological fracture if trauma minimal. Get an X Ray Fractured Pubic ramus May be atypical in elderly or those with delirium or dementia. Consider a pathological fracture if trauma minimal. Get an X Ray Haematoma Anticoagulants and trauma here. May also be secondary to femoral artery puncture. Watch Hb. May see bruising. Necrotising fasciitis Severe pain from deep within. Develops erythema and necrotic lesions and bullae and grossly raised CK Rhabdomyolyisis Muscle aches and and elevated CK. Statins ?? Diabetic amyotrophy Pain and some wasting. It affects the thighs, hips, buttocks and legs
Abscess May follow penetrating trauma here or seeding form elsewhere. get an USS and will need drainage Proximal DVT Pain and swelling and venous dilation. Needs USS doppler. Arterial occlusion Pale, cold, painful leg with absent pulses and poor capillary return. Needs urgent vascular review. Meralgia paraesthetica Pregnancy, Obesity. Increased sensitivity and pain over lateral aspect. Needs treatment for neuralgia and possibly local nerve block lateral cutaneous nerve of thigh here Fibromyalgia Localised pain and trigger points usually in a patient with known fibromyalgia Bone sarcoma Localised pain Cellulitis Pain, erythema, margin and may be breaks in skin. Needs antibiotics Myositis Muscle pain - look for rheumatological disease. Check ESR may be weakness.
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Differentials of Painful thigh
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