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Suggest Treatment For Severe Pain And Swelling In The Left Leg

Posted on Fri, 25 Sep 2015

Question: For the Past three week, my son has had severe pain and swelling in the left leg. This has come after he had Typhoid in the past 3 weeks time. He has no fever. He was on admission for the typhoid and the pain started during that time. We have used Diclofenac for about 5 days and there has been minimal improvement

Answered by Dr. Prof. Kunal Saha (1 hour later)

Brief Answer:
Could be due to electrolyte imbalance

Detailed Answer:
Thanks for asking on HealthcareMagic.

Your son could be having electrolyte imbalance or muscle fatigue which could lead to the pain in his legs. Taking juicy fruits like citrus fruits should help since they contain plenty of potassium. Try it for a few days and see if it gives him relief. If it does not make a difference, you might need to get a lower limb ultrasonography done.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Prof. Kunal Saha (6 minutes later)

would you recommend electrolyte replacement drink - like ORS?
Is this related to the typhoid?

Answered by Dr. Prof. Kunal Saha (1 minute later)

Brief Answer:
ORS does not contain a good amount of potassium

Detailed Answer:
You can give ORS but that is for maintenance of overall hydration. It does not provide much of potassium which is needed here.
Although not directly related to the typhoid infection, it can be due to the weakness caused as a sequel of the disease.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Prof. Kunal Saha (22 minutes later)

So it can be fruits like bananas and citrus fruits. He has been craving bananas. Aside fruits, are there any other things we could be doing to help. The pain is bad for him, though it has improved some in the last days. The swelling is really a concern,
also, is there a recommended amount he should be taking each day in terms of fruits

Answered by Dr. Prof. Kunal Saha (2 hours later)

Brief Answer:
Feel free to give him bananas

Detailed Answer:
Bananas are a good source of potassium.
To be able to comment on the amount, I would need to know the age of your child.
It would be preferrable if you could share an image of both the legs so that I could compare the swollen leg with that of the normal leg side by side.
You can give paracetamol/acetaminophen to bring down the pain. Nothing else needs to be done at the moment.
Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Prof. Kunal Saha (5 hours later)

His age is 21. The swollen leg is about twice the size of the other one. The pain is worse around the joints - knee and ankle.

Answered by Dr. Prof. Kunal Saha (12 hours later)

Brief Answer:
You need to visit a doctor and get him evaluated. Medical attention needed.

Detailed Answer:
Thanks for writing back. Sorry for not being able to respond earlier. Previously I had assumed the pain to be in the muscles of the lower limb. But since you mention that the pain is near the knee and ankle, that does not seem to be the case and bony or joint cause seems more likely. In that case taking fruits would not help. Rather you should visit a doctor and get him thoroughly evaluated. Blood tests like Rheumatoid factor and ASO titre might need to be tested. But clinical examination is important and I would insist you to take it on a serious note. There might be reasons to get concerned. Treatment will depend on the clinician's findings,

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Prof. Kunal Saha (4 hours later)

We saw the doctor just on Friday and he seemed to not be too concerned. I think I may have miscommunicated in saying that it is worse around the joints. In fact it is not joint pain but mostly in the muscles. Initially the pain and swelling was mostly in the upper leg (thigh), but has recently been more around the lower leg (calf) and foot. The swelling has followed the pain. When I massage the leg with a muscle rub, it reduced the pain significantly. Today we tried the fruits and in fact he said the pain was much less in the course of the day, but after he took his medicine (he is on ciproflaxacin for the typhoid + a multi-vitamin), he said the pain became worse. I think I mentioned he was on admission for typhoid. In fact it was a serious case - he had developed some schizophreniform symptoms. That is why he was admitted to hospital. So in addition to the cipro, he is on some other psych medications. He has had an x-ray of the limb already with no indication of problems in the joints. If we take him to the clinic, what tests should we be asking for?

Answered by Dr. Prof. Kunal Saha (6 hours later)

Brief Answer:
I would suggest a lower limb ultrasonography

Detailed Answer:
Your present communication indeed explains the condition in more details. It now once again seems to be on the lines that I was thinking earlier. Try giving 2 or 3 portions of fruits a day. When you go to the clinic, you may ask for lower limb ultrasonography (muslce, arterial and venous) of the concerned side. However, his psychiatric illness could also have a contributory role and talking to the psychiatrist about alternate medications could help.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Prof. Kunal Saha (34 minutes later)

We will continue with the fruits and see if there is improvement. What would the ultrasound show?

Answered by Dr. Prof. Kunal Saha (7 hours later)

Brief Answer:
Continue the fruits. They would not do any harm

Detailed Answer:
You should continue the fruits since they would either be beneficial or they would not, but in any case they would not be harmful. In the ultrasound we would look for any muscle pathology or discrepancy in blood supply. Absence of these could indicate fibromyalgia where the psychiatric medicines might need suitable modification.

Regards

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar