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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.
Vitals:
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?
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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 urinationImage: Painful left leg from Shutterstock
