You are seeing Mr. Perera, a 68 year old male, in an outpatient clinic. He’s coming in today because he’s been getting pain in his legs for the last few months, and it’s getting worse. Please take a focused history of his complaint.
History
- Onset and duration of pain
- Quality of pain
- Aggravating factors (pain is elicited by walking)
- Distance travelled that elicits pain (2 blocks)
- Alleviating factors
- Intensity of pain
- Radiation of pain
- Pain at night
- Neurologic symptoms, such as numbness or parasthesias
- Leg trauma
- Asks if both legs are affected (yes)
- Foot ulceration
- Lower limb infection
- Shortness of breath
- Recurrent chest pain
- Personal history of myocardial infarction and stroke
- Peripheral vascular disease
- Diabetes
- Dyslipidemia
- Hypertension
- Smoking history (quantity in pack-years)
- Family history of cardiac or cerebrovascular events
- Effect on daily activities
Case 3 – Pain in Legs