Hi,
I am a student paramedic in the UK and I am hoping someone can give me an idea as to what was the likely diagnosis for a patient I went to. (I am not on placement for a few days and don't have any doctors I can ask in the meantime, plus the patient was transferred to a hospital too far away for me to go and enquire for a definitive answer).
The patient was 47 years old, presenting with severe upper right leg pain, in the hip and thigh area. It had started as aching pain the previous evening however was severe when she woke in the morning - 10/10 pain which had developed into what she described as a sharp 'poking' pain. There was no radiation of pain into the back or down the leg however she complained of numbness and significant reduced sensation to the lower leg and foot which was pale, cold and the pedal pulse was not located. Movement was present but with extreme pain. The patient also complained of dizziness, nausea and quite significant photophobia and developed blurred vision. She had no significant past medical history, no recent surgery and was not on any medications, no allergies, but was overweight. She had no back pain and no bladder/bowel dysfunction. The only other complaint was a slight headache during the night.
She had no history of trauma but had a recent viral infection/cold over the last 2 weeks. Her obs were RR 20, Sats 100%, HR 69, BP 121/85, temp 37.8C and BM 7.4. She was given entonox and morphine which had no effect. I later heard it was a suspected vascular issue but have no more information than that.
I am writing a reflective essay on this patient and so can look into the possible causes and can explore spinal problems/vessel occlusion/DVT etc but I was wondering what was most likely to cause the neurological symptoms. Initially when we arrived we thought it might be sciatic pain and perhaps she was feeling dizzy and nauseated because of the pain however it soon appeared that there was more to it and because my medical knowledge at this stage is fairly limited I can't really come up with the answer myself!
Any thoughts are appreciated thanks!
I am a student paramedic in the UK and I am hoping someone can give me an idea as to what was the likely diagnosis for a patient I went to. (I am not on placement for a few days and don't have any doctors I can ask in the meantime, plus the patient was transferred to a hospital too far away for me to go and enquire for a definitive answer).
The patient was 47 years old, presenting with severe upper right leg pain, in the hip and thigh area. It had started as aching pain the previous evening however was severe when she woke in the morning - 10/10 pain which had developed into what she described as a sharp 'poking' pain. There was no radiation of pain into the back or down the leg however she complained of numbness and significant reduced sensation to the lower leg and foot which was pale, cold and the pedal pulse was not located. Movement was present but with extreme pain. The patient also complained of dizziness, nausea and quite significant photophobia and developed blurred vision. She had no significant past medical history, no recent surgery and was not on any medications, no allergies, but was overweight. She had no back pain and no bladder/bowel dysfunction. The only other complaint was a slight headache during the night.
She had no history of trauma but had a recent viral infection/cold over the last 2 weeks. Her obs were RR 20, Sats 100%, HR 69, BP 121/85, temp 37.8C and BM 7.4. She was given entonox and morphine which had no effect. I later heard it was a suspected vascular issue but have no more information than that.
I am writing a reflective essay on this patient and so can look into the possible causes and can explore spinal problems/vessel occlusion/DVT etc but I was wondering what was most likely to cause the neurological symptoms. Initially when we arrived we thought it might be sciatic pain and perhaps she was feeling dizzy and nauseated because of the pain however it soon appeared that there was more to it and because my medical knowledge at this stage is fairly limited I can't really come up with the answer myself!
Any thoughts are appreciated thanks!
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