I am curious as to what the group could suggest as a
possible diagnosis for this patient:
13 y.o. Ethiopian female with 3 day h/o
atraumatic, acute onset of R LE swelling...from the
thigh down to ankle. Prior to arrival to the ED the
patient had an ultrasound of LE which was neg for DVT.
There is no hx of travel. The patient was last in
Ethiopia 2 yrs ago. First onset of menses began 4
days prior to presentation. Other than the swollen
extremity , there are no other complaints.
On presentation, vitals were stable, afebrile. The
patient is well appearing, in NAD. RLE markedly
swollen with a 3 inch increase in diameter from thigh
to ankle as compared with the LLE. No pitting edema.
The leg is nontender, not warm to touch. The patient
can ambulate without pain or difficulty. The rest of
the physical exam was normal.
CT of the abdomen and pelvis were normal, as were
filarial studies. CBC was normal as well. Total
protein was high at 8.1.
Tom Langston, MD
The early bird may get the worm....but the second mouse gets the cheese.
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