- Approach leg pain with the seconds, minutes, hours mindset – think about acute limb ischemia, compartment syndrome, and necrotizing fasciitis
- Do a thorough physical exam – get their shoes and socks off – you will find crazy stuff when you actually look
- Palpate and image the joint above and below any injury
- Descenders – get the full series – XR calcaneus, LE’s, hips, and spine to evaluate for any injury – this is a high mechanism of injury
- Beware of tibial plateau fractures – they are hard to see a lot times, get a CT if the XR is equivocal or if the patient can’t walk
- Acute limb ischemia is concerning for proximal aortic dissection – obtain CT angio from the chest to the toes
- Talk to your consultants in their language – LRINEC score is not great at ruling out necrotizing fasciitis but it will get a surgeon to the bedside
REBEL Core Cast – Basics of EM – Leg Pain
Click here for Direct Download of the Podcast
Co-Host
Michael P. Jones, MD
Vice Chair for Education and Residency Director
Associate Professor of Emergency Medicine
Albert Einstein / Jacobi + Montefiore
Bronx, NY
Instagram: jacobimonteem
Twitter: @treatNstreetEM @Jacobi_EM
Post Peer Reviewed By: Anand Swaminathan, MD (Twitter: @EMSwami)
Cite this article as: Ellsworth Wright, "REBEL Core Cast – Basics of EM – Leg Pain", REBEL EM blog, June 1, 2022. Available at: https://rebelem.com/rebel-core-cast-basics-of-em-leg-pain/.
