The evaluation of deep venous thrombosis begins with a medical history and physical examination.

Physical findings in someone with a deep venous thrombosis may include:

• Leg swelling (unilateral)
• Calf tenderness
• Thigh tenderness

• D-dimer assay:
• A blood protein that is elevated in people with deep venous thrombosis.
• Angiodynography
• Duplex ultrasound:
• Now the diagnostic method of choice due to its high accuracy and low risk of complications
• MRI scanning of the pelvis:
• Can accurately detect clots within the renal veins and pelvis
• Other methods for imaging clots include:
• Impedance plethysmography
• Radiolabeled fibrinogen (nuclear scan)
• Venogram:
• An x-ray is taken of the veins

Conditions that can cause symptoms similar to deep venous thrombosis include:

• Abscess
• Acute arthritis
• AV fistula
• An abnormal connection between an artery and a vein
• Baker's cyst
• Can cause swelling in the calf
• Cancer
• Capillary leak syndrome
• Tiny blood vessels abnormally leak fluid into the tissues
• Cellulitis
• Compartment syndrome
• Congestive heart failure
• Hypoproteinemia:
• Low concentration of proteins in the bloodstream
• Leg fracture
• Lymphedema
• Swelling due to a blockage in the lymph channels in the leg
• Muscle strain with hematoma
• Myositis
• Nerve root irritation
• Sciatica
• Post-phlebitic syndrome:
• Persistent leg swelling, leg pain, and bruising in the affected leg
• Superficial thrombophlebitis

Last Updated: Dec 9, 2010 References
Authors: Stephen J. Schueler, MD; John H. Beckett, MD; D. Scott Gettings, MD
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