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Thigh Pain

UnFiNiShEd CaSe CoMe BaCk LaTeR

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History of Present Illness:

A female in her 60s with a history of DM presents to the ED for 3 days of inner right thigh pain and redness and vaginal discharge.  Last sex was 7 days ago with stable partner.  Pain worse to sit on. No fever but some chills a few days ago

Vital Signs & Physical Exam:

Vital signs are normal except for  a temperature of 101.4.  BP and pulse are normal  Physical exam is otherwise normal except for a 2% TBSA area of redness and tenderness to the upper inner thigh.

Initial Differential Diagnosis:

  • Cellulitis
  • Other infection

Initial Diagnostic Testing:

  • Labs: WBC and bands both 15.  Glucose 400, lactate and creatinine both 2.2, sodium and gap normal

QUESTIONS:

  1. What other test should you consider?  
  2. What should you do next?
  3. Want a 1-minute consult/tutorial on this case? 
  4. Want to know what happened with this patient?

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ANSWERS:

  1. What other test should you consider?  
  2. What should you do next?  Treat with.  Consult.
  3. Want a 1-minute consult/tutorial on this case?  See yellow area from sample page below.
  4. Want to know what happened with this patient?  See case conclusion below tutorial page.

1-Minute EM Consult on the topic for this case from the Emergency Medicine 1-minute Consult Pocketbook

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CASE CONCLUSION: We’ll just have to see

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