REBEL Core Cast – Basics of EM – Leg Pain

Take Home Points

  • 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


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:

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