Authors: Sophie Lewis / Editor: Nicholas Tilbury / Reviewer: Syed Ali Junaid Gillani / Codes: PC3, PhC1, PhP2, SLO1, SLO2, TC1 / Published: 16/04/2020 / Reviewed: 13/04/2025
A 38-year-old gentleman presents confused and drowsy. He has a background of fibromyalgia and previous IV drug abuse. His regular medications include zomorph, oramorph, diazepam and zopiclone.
The patient attended the Emergency Department (ED) with a swollen left calf the previous day when he was treated for a DVT, which was confirmed on a doppler ultrasound.
His observations are stable. Bloods show urea of 48 and creatinine of 899 and he has a creatinine kinase of 102,5788. ABG shows metabolic acidosis. The patient does not complain of pain but his left lower limb is swollen and tense. He is unable to dorsiflex and tells you he can’t feel his left leg.
14 responses
A presentation not to miss
Very useful module. One not to miss.
Good pick up
Nice module which is similar to the case I saw with upper limb swelling and his CK was 22000, was admitted under orthopaedic to role out compartment syndrome
Very interesting case
Useful info
Good case, easy to miss in the obtunded patient
Very important and time sensitive case for diagnosis and management.
Well-summarized clinical case
Very nice module.
informative
Interesting,very well written
Thanks for sharing
educative
informative