National Physical Therapy Examination (NPTE) Practice Exam

In a patient presenting with constant bilateral posterior calf pain and crusting of the skin, which condition is most likely present?

1. Dermatitis

2. Cellulitis

3. Atrophie blanche

4. Superficial venous thrombosis

The correct answer is: Dermatitis

The patient’s symptoms of constant bilateral posterior calf pain combined with crusting of the skin strongly suggest a condition associated with venous insufficiency or chronic venous disease, rather than dermatitis. Dermatitis typically presents with pruritus, redness, and possibly vesicles or scaling but is less likely to be characterized by constant pain in the posterior calf region. Atrophie blanche, while related to chronic venous insufficiency, manifests with white, atrophic patches and can be associated with pain; however, the key feature of crusting in the presented case is more indicative of changes associated with venous stasis or other skin complications such as ulcers. Cellulitis would present with more acute symptoms such as redness, swelling, heat, and systemic signs of infection, which are not mentioned here. Superficial venous thrombosis would typically refer to thrombosis of the superficial veins, which can cause localized pain and tender, cord-like structures, but does not usually present with crusting of the skin. Thus, the combination of bilateral calf pain and crusting aligns more closely with the skin and vascular changes associated with chronic venous insufficiency, potentially leading to venous ulcers or other complications rather than dermatitis.