Updated 27 August 2015

What's your diagnosis? – Case 24: painful and swollen leg

Mrs L, a 38-year-old air hostess, is suffering from a painful and swollen leg. Consult your textbooks and see if you can solve this week's case.


Mrs L goes to the doctor with a painful left lower leg that started swelling the previous day. En route to Cape Town from London, she noticed her leg was painful, but she thought that she might have bumped it against a seat in the airplane, or strained a muscle when she went for a run. She also noticed that her lower leg had become swollen.

Mrs L remembers that one of her colleagues recently had similar symptoms, which turned out to be an infection. She can't recall the details of her colleague's case.

She has no medical history, and only takes oral contraceptive pills. She has no surgical history and no family history of disease. She does smoke and use alcohol occasionally.

On examination, her doctor noticed the following:

1. Significantly swollen left lower leg with a tense calf. Tender on touch, warm compared to right lower leg.

2. Pulses in the lower leg all present, although not easy to palpate.

3. Left lower leg appears redder than the right one.

Cardiac, respiratory and abdominal examination normal.

Slight decreased power in left leg compared to right leg. Reflexes normal.


Heart rate: 88

Breathing rate: 15

Blood pressure: 145/92

Side Room:

Urine: clear

Haemoglobin: 15

Based on the above information, and particularly Mrs L's history, what is the most likely diagnosis?

NOTE: Health24's on-site GP Dr Owen Wiese reveals new cases on Thursdays. The answer is posted with the story on Mondays, or you can get it in our Daily Tip – sign up here.

Previously on What's Your Diagnosis?

What's your diagnosis? -  Case 1: vomiting and weight loss

What's your diagnosis? -  Case 2: eye pain

What's your diagnosis? -  Case 3: strange behaviour and a bullet in the back

What's your diagnosis? -  Case 4: seeing odd things

What's your diagnosis? - Case 5: mysterious lungs

What's your diagnosis? - Case 6: runner with seizures

What's your diagnosis? - Case 7: swollen knee

What's your diagnosis? - Case 8: bloody semen

What's your diagnosis? - Case 9: confusing neurological signs

What's your diagnosis? - Case 10: diabetic teenager with unusual signs and symptoms

What's your diagnosis? - Case 11: bruising with no apparent reason

What's your diagnosis? - Case 12: severe tummy pain

What's your diagnosis? - Case 13: severe sore throat

What's your diagnosis? - Case 14: abdominal pain and swelling

What's your diagnosis? - Case 15: the world is spinning

What's your diagnosis? - Case 16: numbness in forearm

What's your diagnosis? - Case 17: burning urine

What's your diagnosis? - Case 18: boy with persistent fever

What's your diagnosis? – Case 19: lady who can't lose weight

What's your diagnosis? – Case 20: chest pain next to breastbone

What's your diagnosis? – Case 21: burning sensation in vagina

What's your diagnosis? – Case 22: vomiting and headaches

What's your diagnosis? – Case 23: frequent urination

Image: Painful left leg from Shutterstock

Dr. Owen J. Wiese is Health24's resident doctor. After graduating from Stellenbosch University with additional qualifications in biochemistry and physiology he developed a keen interest in providing medical information through the media.


Read Health24’s Comments Policy

Comment on this story
Comments have been closed for this article.

Live healthier

Exercise benefits for seniors »

Working out in the concrete jungle Even a little exercise may help prevent dementia Here’s an unexpected way to boost your memory: running

Seniors who exercise recover more quickly from injury or illness

When sedentary older adults got into an exercise routine, it curbed their risk of suffering a disabling injury or illness and helped them recover if anything did happen to them.