| Cause of Painful Thigh |
Comments |
| 🦴 Fractured Femur |
May be atypical in elderly, especially with delirium/dementia. Consider pathological fracture if trauma is minimal. Always get an X-ray. |
| 🦴 Fractured Pubic Ramus |
Common in frail elderly women. Pain may be subtle; mobility often impaired. X-ray or CT pelvis may be required. |
| 🩸 Haematoma |
Often in patients on anticoagulants or after trauma/femoral puncture. Monitor haemoglobin. May see bruising/swelling. |
| ⚡ Necrotising Fasciitis |
Severe “pain out of proportion.” Rapid progression with erythema, necrosis, bullae. CK markedly raised. Surgical emergency. |
| 💊 Rhabdomyolysis |
Muscle pain with elevated CK. May follow crush injury, statins, seizures. Risk of AKI → monitor U&E. |
| 🦵 Diabetic Amyotrophy |
Thigh/hip pain with wasting and weakness. Seen in poorly controlled diabetes. Often asymmetric. |
| 💉 Abscess |
May follow penetrating trauma or haematogenous spread. Look for fever, swelling, fluctuant mass. Confirm with ultrasound; drainage usually required. |
| 🩻 Proximal DVT |
Pain, swelling, venous dilation. Risk factors: immobility, malignancy, surgery. Confirm with Doppler ultrasound. |
| ⛔ Arterial Occlusion |
Pale, cold, painful leg with absent pulses and poor capillary refill. Acute limb ischaemia → urgent vascular referral. |
| ⚡ Meralgia Paraesthetica |
Lateral thigh burning pain/numbness due to lateral femoral cutaneous nerve entrapment. Risks: obesity, pregnancy. May need neuropathic pain relief or nerve block. |
| 🌸 Fibromyalgia |
Chronic pain syndrome with trigger points. Associated fatigue, poor sleep, mood disturbance. |
| 🦠 Cellulitis |
Localised pain, erythema, warmth, and swelling with systemic features. Entry site often visible. Requires antibiotics. |
| 🦴 Bone Sarcoma |
Persistent, localised bone pain (may worsen at night). Consider if unexplained, especially in younger patients. |
| 💢 Myositis |
Muscle inflammation with pain and weakness. Often autoimmune (e.g. polymyositis, dermatomyositis). ESR/CK raised. |