Ask a doctor on the topic of General medicine

"Display window" disease?

February 23, 2012 | 10,00 EUR | answered by Dr. med. Ralf Berg

I have been experiencing severe pain in my left calf for days, only when walking! It feels like a tendon is about to tear soon.
I am 68 years old, currently in Spain until May.
My medications:
Tamsulosin continuously
Currently taking Colchicine, as Allopurinol did not eliminate the gout in my right toe.
For severe pain, I alternate between Diclofenac suppositories and Ibuprofen 400.

Dr. med. Ralf Berg

Dear Inquirer,

A retinal detachment is not usually indicated by the symptoms you have described. This comes as a surprise to you.
There are two possible diagnoses to consider:
1. Peripheral Arterial Occlusive Disease (PAVK) =
(also known as intermittent claudication, where symptoms improve after a short walking break) = Poor blood circulation in the leg, in the initial stage only during exertion and movement. The leg appears pale/white and cool after exertion or otherwise normal.
Risk factors: long-term smoking, long-term hypertension, elevated blood lipids, obesity, atherosclerosis.
Diagnosis through arterial Doppler ultrasound.
Countermeasures: cessation of smoking, regular walking exercise, weight loss.
2. Less likely but more dangerous, a (incipient) deep vein thrombosis in the lower leg:
If the following signs are also present, please consult a doctor:
Swelling of the leg, bluish discoloration, transition to pain at rest.
Diagnosis: D-dimer test, venous Doppler ultrasound, clinical findings.
Treatment: anticoagulation therapy (heparin therapy), compression bandages.

Of course, a muscle strain is also a possibility, but in most cases, the onset is noticeable. This was not the case with you.

Conclusion: For no 1, see a doctor occasionally for examination. If 2 is suspected, see a doctor tomorrow.
With best regards to Spain,
Your Dr. R. Berg