ABSTRACT
A 47-year-old man presented to hospital complaining of worsening bilateral foot pain and weakness that was worse when he walked or ran. The symptoms had developed over the preceding 2 days, with pain initially present in the arches of his feet only. The pain progressed to involve his heels over the next 24 hours and was described as an intense, burning pain. His calves had been tender to touch on the morning of presentation. He complained of feeling as though his legs may give way when walking, but suspected that the weakness may be secondary to pain. He denied recent trauma to the lower limbs. He took spinning classes once weekly and had initially attributed his symptoms to post-exercise myalgia. He denied recent immobility or long-haul travel, and had no previous or family history of venous thromboembolism. His past medical history included asthma and a diagnosis of cleft palate at birth, which had been corrected in infancy. He took no regular medications. The patient worked as an office manager and lived alone. He denied ever smoking and usually drank 15–20 units of alcohol per week. He denied recent unprotected sexual intercourse. He travelled to Austria three times per year to visit family.
