Calf Swelling : Differentials

Lower limb swelling is a common presenting complaint in primary care settings and can stem from a variety of causes. Effective management of this condition requires a comprehensive approach, beginning with a detailed patient history. This history is crucial for guiding subsequent diagnostic testing and management strategies in a cost-effective manner.

Clinicians should carefully evaluate the characteristics of the swelling, including its location (unilateral vs bilateral, and if bilateral, whether it is symmetrical or asymmetrical). It is also important to assess any changes in the severity of the swelling with different positions and times of the day, as these can provide valuable clues to the underlying cause. While swelling may sometimes be asymptomatic, it is often associated with symptoms such as aching, pain, and heaviness. Additional indicators to look for include characteristic venous or lymphatic skin changes, and any history of prior or active ulcerations on the lower limb. The onset of the swelling—whether sudden, gradual, or long-standing—also plays a pivotal role in the differential diagnosis.

Given the range of potential causes, a structured approach to diagnosis is essential. The following table outlines the various conditions that could lead to unilateral leg swelling, along with their respective symptoms and...