A patient comes in complaining of swelling to her right foot. No pain. No injury. Just swelling.
A quick glance at the patient’s foot showed that there was no swelling whatsoever. Examination … nothing. Range of motion … normal. However, the patient insisted that her foot was swollen.
“Where do you feel that your foot is swollen?”
“Look. Right here,” pointing at the outer ankle.
“Um … ma’am. That’s your ankle.”
“No … that’s swelling.”
So I went and got a tape measure. I measured around both feet, around both ankles, and around both lower legs, then compared numbers. Exactly the same in both legs.
“See? The sides are the same. No swelling.”
“Yeah, well your tape measure is wrong.”
“But I used the same tape to … Nevermind. Well. This is kind of beyond the scope of my practice. I think I’m going to need to refer you to the vascular surgeon and the orthopedist to be worked up for the swelling. In the meantime, we’ll wrap your foot with an ACE bandage and you’re welcome to take some Motrin for your symptoms. Have a nice day.”
If you have a patient story you’d like to see published on this blog, please e-mail it to me at whitecoat at epmonthly dot com.