Deep vein thrombosis physical examination

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Editors-in-Chief: C. Michael Gibson, M.S., M.D. Associate Editor-In-Chief: Ujjwal Rastogi, MBBS [1]

Deep Vein Thrombosis Microchapters

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Patient Information

Overview

Classification

Pathophysiology

Causes

Differentiating Deep vein thrombosis from other Diseases

Epidemiology and Demographics

Risk Factors

Triggers

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Approach

Assessment of Clinical Probability and Risk Scores

Assessment of Probability of Subsequent VTE and Risk Scores

History and Symptoms

Physical Examination

Laboratory Findings

Ultrasound

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Upper extremity DVT

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Pregnancy

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Case #1

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Overview

The actual physical signs of venous thrombosis can be quite unreliable. There may be pain and tenderness in the thigh along the course of the major veins

Appearance of the Patient

Obesity may be present.

The patient may complain of lower limb pain.

Vitals

Temperature, Blood Pressure, Pulse and Respiratory rate may all be within normal range.

Extremities

Physical examination may reveal

  • Palpable cord (reflecting a thrombosed vein)
  • Calf or thigh pain
  • Unilateral edema or swelling with a difference in calf diameters, warmth, tenderness and erythema.
  • Superficial venous dilation.

Screening for malignancy

Venous thromboembolism may be the first manifestation of an underlying malignancy. However, a detailed and routine search for an occult malignancy is neither mandatory nor cost effective.[1]

The following test should be considered:

In Males

In Females

  • Pelvic examinations to rule out any mass/malignancy.

References

  1. Oudega R, Moons KG, Karel Nieuwenhuis H, van Nierop FL, Hoes AW (2006). "Deep vein thrombosis in primary care: possible malignancy?". Br J Gen Pract. 56 (530): 693–6. PMC 1876636. PMID 16954002.

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