Question of the Week # 414

414) A 62-year-old software engineer presents with complains of mild pain and swelling in his right lower extremity which has been progressively increasing over the past 6 months. The swelling is more towards the end of the day. Pain is worse on walking or standing and gets better with rest. On examination, vitals are stable. There is non-pitting edema of right lower extremity below the level of the knee. The limb looks normal above the level of the knee. There is some bluish discoloration of the skin over the distal portion of the leg. Small intradermal bluish vessels are noted in the skin of her right lower extremity. Dorsalis pedis and tibial pulses are intact. Which of the following is the most likely diagnosis?

A) Chronic Venous Insufficiency

B) Phlegmasia Alba Dolens

C) Phlegmasia Cerulea Dolens

D) Lymphedema

D) Peripheral Arterial Disease

14 Responses

  1. c

  2. a

  3. a) chronic venous insufficiency

  4. D

  5. C.

  6. A

  7. A

  8. A) Chronic Venous Insufficiency

  9. A) Chronic venous insufficiency
    -swelling more prominent toward the end of the day,
    -bluish discoloration of the skin over the distal portion of the leg and
    -small intradermal bluish vessels in the skin

  10. c

  11. c

  12. ~A
    Chronic venous insufficiency.

  13. hw do we differentiate venous insuficiency and lymphedema here? does venous insufficieny pain improve wth rest?thanks

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