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What Does Severe Leg Pain In An Elderly Person Indicate?

Posted on Sat, 17 Dec 2016

Question: My 91 year old father has had R-leg pain from knee to foot for at least 3 months. MRI, CT and xrays showed nothing. Shortly before that started he was diagnosed with Afib and had a pacemaker placed with good results. A hematologist is treating him for anemia. Last week I saw his foot is reddened and cool with a small skin breakdown between 2-toes. Within a couple of days two toes are involved; red, more breakdown, and foot cold. Dr. put him on ABT and has referred to wound care. I feel something more aggressive should be done. He has no other diagnosis. Is it PVD? PAD? Thank you.

Answered by Dr. Albana Sejdini (1 hour later)

Brief Answer:
Need further information, see below...

Detailed Answer:
Hi,

I am sorry for the health situation your father is in.

There are various factors causing leg pain in a 91 years old patient with a personal history of placed pacemaker and Afib. I believe doctor has put him on therapy with blood thinners.

Now, you are referring some changes in his toes. Can you please send a photo of them, so I could be able to analyze these changes myself and give a more specific advice?

Furthermore, you are right, he should be run further diagnostic tests to rule out:
- deep vein thrombosis through Doppler ultrasound
- neuropathy through neurological examination

As the wound is not healed properly, diabetes testing is advised to rule out diabetes. To your information, diabetes makes it difficult for wounds to get healed.

If you have any blood test reports, you can send to me for further evaluation.

I need all these data to analyze his case specifically before running into final conclusions.
Thank you.
Dr.Albana

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