DIAGNOSIS CHECKLIST
for Calf pain

Why: to determine if acute or chronic e.g. if sudden and severe calf pain not related to trauma must consider acute lower limb ischemia (sudden obstruction of blood supply from thrombosis (clot) or embolism (plug).

Why: if deep and very localized and not generalized must consider bone tumor, fracture or rarely infection; if superficial must consider muscular pain.

Why: if not must consider a vascular cause of calf pain e.g. vein or artery blockage or rupture.

Why: if not the calf pain is referred e.g. from spine or hip.

Why: if pain is related to movement may be due to bone or joint problems; if pain is not related to movement the pain must arise from a soft tissue lesion e.g. artery or vein blockage.

Why: e.g. worse with sitting suggests spinal cause; worse with standing may suggest a local problem related to weight bearing e.g. varicose veins; worse lying down may suggest peripheral vascular disease.

Why: e.g. immediate onset with walking suggests stress fracture; delayed onset with walking suggests intermittent vascular claudication or sciatica.

Why: children can experience "growing pains" which are usually related to excessive exercise or trauma from sport. The pains are intermittent and symmetrical and deep in the legs, usually front of thighs or calves. They typically occur at night in bed and last for 30-60 minutes.

Why: e.g. anemia can precipitate peripheral vascular disease;

Why: e.g. cigarette smoking, high blood pressure, high cholesterol, diabetes, atrial fibrillation, family history - may indicate intermittent claudication as cause for calf pain.

Why: e.g. female sex, family history, pregnancy, increasing age, standing occupations, low fiber diet.

Why: beta-blocker blood pressure medications can worsen peripheral vascular disease.

Why: e.g. back pain radiating down legs, weakness, burning, numbness in legs, may be associated with bowel and bladder symptoms if severe.

Why: e.g. sudden severe calf pain, pallor of skin, paresthesia or numbness of lower leg, paralysis or weakness of leg.

Why: e.g. pain in buttock, thigh and calf, especially when walking up hills and stairs, persistent fatigue over the whole lower limb, impotence is possible, if severe pain occurs at rest especially at night.

Why: e.g. swelling of feet, leg fatigue, leg heaviness, itching.

Why: e.g. diffuse leg swelling, leg warmth, ankle pitting edema.