Online Health Advice > leg pain >

Ask Your Health Question. Health Experts Answer You ASAP.

(Not a Health Question?)

may 11th inner thigh was painful almost burning. 2 weeks later pain on and behind knee.3wks later back of calf. the other day right above inner ankle. couple hours ago leg was tingling and numb off and on. any ideas

Optional Information:
Male , Age: 31

Already Tried:
dr.s

Customer (name blocked for privacy)

Status: Closed Value: $10

Hi Customer (name blocked for privacy), welcome to JA. Are you experiencing any visible symptoms in the affected leg? (swelling, color changes..) Is the leg colder than the unaffected leg? Do you have any chronic medical conditions, or take any medications regularly, are you Diabetic? Are you having pain or soreness in your back, hip or knee? Under already tried you listed "dr.s". Have you been evaluated by a Physician, or received any testing?

I hope my information is helpful. If you have more questions, just ask! I will gladly help, otherwise please click "accept".
Positive feedback and any bonus would be appreciated. Thank you, Christy

Reply to Christy Hammond's Post: nothing visable but feels tighter most of the time.its not colder than the other. been taking nexium for about 1 yr. pain in knee at times. i've had 2 d-dimers, 2 dopplers.

Nerve entraptment or compression can cause the sensation you describe. Soft tissue inflammation/injury, joint disorders, and back injury are underlying conditions commonly related to nerve compression/entraptment.

After ruling out circulation issues, and since your symptoms persist, you should be evaluated by an orthopoedist and/or neurologist. A physical exam, history of symptoms and imaging sudies such as MRI, should be able to determine the root cause of these symptoms.

In the meantime, an NSAID (ibuprofen, Advil, Motrin etc.) taken continuously for 2-3 days, rest, ice to areas of pain, epsom salt soaks, and elevation of affected leg when at rest may improve symptoms. Do not lift over 2-3 pounds, engage in strenuous activity, sit with legs dependant, or stand for long periods.

Seek immediate medical care if leg becomes icy cold, blue or white, numb or paralyzed for more than a few minutes, or if you experience sudden sharp pain in leg(s), chest or back, feel short of breath, cough up blood, or become dizzy or weak.

I hope my information is helpful. If you have more questions, just ask! I will gladly help, otherwise please click "accept".
Positive feedback and any bonus would be appreciated. Thank you, Christy

Reply to Christy Hammond's Post: my concern for the last month or so has been dvt.i read if a d-dimer test is taken too soon or delayed for several days it could show a false neg. in my case it was taken 3wks and again at 4wks later after initial symptoms. how often does a false neg. come up if its after several days?

The D-Dimer false result is more likely to be a false positive than false negative. A negative result may be used to rule out DVT, but positive results are not used to diagnose DVT, only as evidence of a need for further testing. In effect the D-Dimer is only one part of a profile and has limited meaning on it's own. Timing can effect the D-Dimer test, but taken together with your symptoms, negative Doppler studies, limited risk factors they are not suggestive of DVT .

I hope my information is helpful. If you have more questions, just ask! I will gladly help, otherwise please click "accept".
Positive feedback and any bonus would be appreciated. Thank you, Christy

Reply to Christy Hammond's Post: sorry to get back to you so late. my comp. was running slow yesterday and i was tired.
i just fear dvt. i scwat and am on my knees alot at work (up to 30 min.at a time). when i get up i usaully get numb legs and pain behind the knee. i think day after day of this it could of slowed my blood up to cause a clot. also i feel a cramp type feeling centered at the knee and going up to about my butt and down to bottom of calf. what could cause this?
(other ?'s of concern)
how much can timing affect the d-dimer test?
and if the clot were behind my knee or in the pelvis would a doppler even show a little bit of something out of the ordinary?

Edited by Customer (name blocked for privacy) on June 22 2006 at 9:48 PM

Relist: No answer yet.

I'm sorry for the delay. I was compiling some clinical study stats for your answer when my power went out for several hours.

I fully understand your concern even fear of developing DVT. It is easy to focus on the most threatening possibilities when experiencing unexplained symptoms.

The risk factors for DVT are:
Inactivity.
Prolonged best rest.
Certain surgical procedures.
Some medical conditions. (cancer, high blood pressure and cardiovascular disease make clot formation more likely, as does having an inflammatory bowel disease
Being overweight
Pacemakers or venous catheters
Pregnancy and childbirth
Birth control pills, hormone replacement, steroid use
Family history
Smoking

Symptoms may include:
only noticable by a doctor:

No symptoms
Mild symptoms
Leg pain
Leg swelling
Leg warmth
Enlarged leg veins
Protruding leg veins
Leg pain on walking
Leg pain when standing
Leg pain absent when seated with legs raised

Because DVT can be life threatening it is one of the first potential concerns investigated when symtoms appear, regardless of risk factors.

D-dimer tests have a 97% accurracy for RULING OUT DVT. Less than 3% of patients with negative results on D-dimer tests later had DVT or PE detected with other tests. It has a high rate of false positive results because of low specificity. Even a positive result does not indicate DVT, only a need for further testing.

Sensitivity is compromised by false negative results if the D-dimer level is measured too early or too late after the initiation of thrombosis. Some investigators have reported negative results on the day of presentation and 7 days after initial symptoms. Falsely negative results can also occur after initiation of anticoagulant therapy. This is one reason for the 3% margin of error.

Doppler studies are either the next step after a positive D-dimer, or may be performed at the same time. Studies have shown them to be up to 98.4% accurate.

A venogram or phlebogram, is a test in which dye is injected into a vein and an x-ray is taken. This is more invasive, but considered the gold standard of diagnosis. If the Doppler study is suggestive, or if evidence of a clot is very strong despite a negative doppler , this is the next step.

Judging by the information you provided your risk factors are low (standing and squatting for long periods are minor risk factors for DVT). Your D-dimer tests were negative, as was your doppler.

It is time to investigate the other possiblities for your symptoms.

Pain or cramp behind the knee is reported with nerve entrapment, phlebitis, varicose veins, and baker's cysts. If symptoms continue a CT or MRI is likely indicated.

There is no harm in taking steps to prevent DVT from occuring in the future, and to be aware if further symptoms suggestive of DVT or PE arise (color changes, temp changes, chest pain, Short of breath...). Be careful not to throw the dart and then draw a bull's eye around it. (which is to say: don't focus on DVT and look for proof it exists) Relief of your symptoms depends on considering all possibilities and makin an accurate diagnosis.

I hope my information is helpful. If you have more questions, just ask! I will gladly help, otherwise please click "accept".
Positive feedback and any bonus would be appreciated. Thank you, Christy

Think you can answer this question?
Login or Become an Expert

DISCLAIMER: You acknowledge that any information you may obtain from individuals you contact through use of the Just Answer service comes from those individuals, not from Just Answer!, and that Just Answer is not in any way responsible for any of the information these third parties may supply. The site and services are provided "as is" with no warranty and no representations are made regarding the qualification of an Expert. Responses and comments on Just Answer! are for general information and are not intended to substitute for informed professional advice (such as medical, legal, investment or accounting) and do not establish a professional-client relationship. Just Answer! is not intended or designed to address EMERGENCY QUESTIONS which should be directed immediately by telephone or in-person to qualified professionals. Please carefully read the Terms of Service.

Just Answer! > Online Health Advice

Related Answers