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Have leg pain , lower leg and foot is swollen. had surgery to remove bone on toe. Suggest cure?

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General & Family Physician
Practicing since : 2009
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My mother is 81 years old. When she wakes up in the morning and stands up her lower left leg and foot is swollen. She often has pain in this leg during the day. She recently had surgery on her left pinkie toe to have a piece of the bone removed. She states that this was not a problem prior to the surgery. She is in excellent health, maintains an healthy diet, and active independent lifestyle.
Posted Sun, 4 Aug 2013 in General Health
Answered by Dr. Luchuo Engelbert Bain 2 hours later
Hi and thanks for the query,

Swelling of one leg diseases a close evaluation. This indicates that the problem should be a local lesion affecting this limb. Appreciating the extent of swelling could be of importance. If the swelling actually extent up to the level of the calf or not. Other clinical signs like redness, visualizing superficial and dilated veins on the legs is important and any changes in the color of the skin on this leg are important. If present, it s possible that this should be a deep veinous thrombosis, which could require specific management procedures. A clinical examination to exclude any swollen lymph nodes is important. Recent manipulation of a toe is a possible source to cause an inflammatory reaction either due to infection or trauma and release of specific mediators of inflammation. The swelling of these lymph nodes could be a normal immunologic reaction, but with compression of the lymphatic drainage system causing this swelling of the limb.

Deep veinous thrombosis and lymphatic system obstruction by probable lymph node enlargement are the most probable etiologies that deserve a formal exclusion. Rare but severe complications like pulmonary emboli could set in in case these conditions are not properly management.

A clinical review, serum D dimer measures a complete blood count, measurements of erythrocyte sedimentation rate and C reactive protein are sufficient to make an appropriate diagnosis and orient management. A Doppler ultrasound or phlebography of the lower limbs could also be of use especially to exclude deep venous thrombosis.

Thanks and hope this helps as I wish your mum the best of health. Consulting an internist or family care physician on time is my advice. Kind regards.

Bain LE, MD.
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