Which Specialist to Consult for Persistent Leg Swelling After Car Accident? - Surgery

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In the aftermath of a car accident, persistent leg swelling can be a concerning symptom that warrants careful evaluation. Given your situation, where you've already consulted multiple emergency departments and received differing opinions on treatment, it's crucial to approach this systematically.

Firstly, it's important to understand that leg swelling can arise from various causes, especially following trauma. Common reasons include soft tissue injury, deep vein thrombosis (DVT), compartment syndrome, or even lymphatic issues. Since you mentioned that you have no visible external injuries and your X-rays did not reveal any fractures, the swelling could be due to soft tissue damage or fluid accumulation.


Which Specialist to Consult?
1. Orthopedic Specialist: Since you have already undergone X-rays, an orthopedic doctor can evaluate any potential musculoskeletal injuries that may not be visible on standard imaging. They can assess for any soft tissue injuries, such as ligament or tendon damage, that could contribute to swelling.

2. Vascular Surgeon: Given your concern about compartment syndrome and the risk of DVT, consulting a vascular surgeon may be beneficial. They can perform Doppler ultrasound studies to check for blood clots in the veins of your leg, which can cause swelling and pain.

3. Physical Medicine and Rehabilitation (PM&R) Specialist: Also known as physiatrists, these specialists focus on rehabilitation and can help manage pain and swelling through non-surgical methods. They can provide a comprehensive rehabilitation plan that may include physical therapy, medication management, and other modalities.

4. General Practitioner (GP): If you're unsure where to start, your GP can provide a referral to the appropriate specialist based on your symptoms and medical history. They can also help coordinate your care and ensure that all aspects of your health are considered.


Treatment Considerations
- Ice Therapy: While one doctor advised against ice, it is generally accepted that ice can help reduce swelling and pain in the acute phase of an injury. Applying ice for 15-20 minutes every hour can be beneficial, but make sure to wrap the ice pack in a cloth to prevent frostbite.

- Elevation: Keeping your leg elevated can help reduce swelling. Try to elevate your leg above the level of your heart when resting.

- Compression: Using compression stockings or wraps can help manage swelling. However, be cautious not to wrap too tightly, as this could exacerbate swelling or lead to complications.

- Monitoring Symptoms: Keep track of any changes in your symptoms, such as increased pain, changes in color or temperature of the leg, or any new symptoms like shortness of breath, which could indicate a more serious condition like DVT.


Follow-Up Care
It’s essential to follow up with the recommended specialists for ongoing evaluation and treatment. They may suggest further imaging studies, such as an MRI or ultrasound, to get a clearer picture of the underlying issues. Additionally, they can provide guidance on physical therapy to strengthen the affected area and improve mobility.

In summary, while it can be frustrating to navigate differing medical opinions, focusing on consulting the right specialists—orthopedic, vascular, or rehabilitation—will help you get the appropriate care for your persistent leg swelling. Always prioritize your health and seek immediate care if your symptoms worsen or if you experience new concerning signs.