Case 2 – Limb Pain

You are seeing Ms. Richards, a 45 year old female, in the ER for a two day history of right leg pain. Please perform a focused history and physical examination.


  • Onset and duration of pain
  • Severity of pain
  • Location of pain
  • Alleviating and aggravating factors
  • History of trauma to leg
  • Leg swelling
  • Neurologic symptoms in affected limb
  • Association with shortness of breath
  • Fever
  • Diaphoresis
  • Chest pain
  • Hemoptysis
  • Personal history of clotting disorders
  • Personal history of malignancy
  • Pregnancy history
  • Use of hormone replacement or oral contraceptive pill (patient uses OCP)
  • History of immobilization
  • Recent leg trauma
  • Medications/Allergies
  • Smoking history (quantity in pack-years)
  • Family history of thromboembolic disease (DVTs, PEs)

Physical Examination


  • Inspects for swelling, edema
  • Inspects for erythema and varicosity in affected limb
  • Inspects for venous ulcers in lower limbs
  • Inspects for joint effusions in affected limb


  • Palpates affected lower limb for tenderness
  • Compares limbs for warmth
  • Measures and compares calf circumference for each limb
  • Assesses sensation in affected limb
Case 2 – Limb Pain