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Clinical presentation and diagnosis of the nonpregnant adult with suspected deep vein thrombosis of the lower extremity

Authors
Clive Kearon, MB, MRCP(I), FRCP(C), PhD
Kenneth A Bauer, MD
Section Editors
Lawrence LK Leung, MD
Jess Mandel, MD
Deputy Editor
Geraldine Finlay, MD

INTRODUCTION

Lower extremity deep venous thrombosis (DVT) and pulmonary embolism (PE) are two manifestations of venous thromboembolism (VTE). Given the risks associated with untreated lower extremity DVT (eg, fatal pulmonary emboli) and the risk of anticoagulation (eg, life-threatening bleeding), accurate diagnosis of DVT is essential.

The approach described in this topic applies to nonpregnant adults. The evaluation of pregnant women with suspected DVT and the treatment of DVT are discussed separately. (See "Deep vein thrombosis in pregnancy: Epidemiology, pathogenesis, and diagnosis", section on 'Diagnostic algorithm' and "Overview of the treatment of lower extremity deep vein thrombosis (DVT)".)

CLINICAL PRESENTATION

Features of lower extremity DVT are nonspecific and many patients are asymptomatic.

History — DVT should be suspected in patients who present with leg swelling, pain, warmth, and erythema [1-3]. In one series, the sensitivity and specificity of these findings were [4]:

Swelling or edema – 97 and 33 percent

                              

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Literature review current through: May 2017. | This topic last updated: Mar 24, 2017.
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