Can you make the diagnosis?

A 36-year-old woman has just returned to work after knee surgery three weeks prior.  She is at her desk when she notices that her left leg (the same side as the surgery) has pain in the calf, and the ankle appears swollen.

The patient’s only medical history is knee surgery.  She has no other health problems.  Her only medication is birth control pills.

What should this patient do?

  1.  Take an Advil and go back to work.
  2. Ask her husband to massage her leg when she gets home.
  3. Call her primary care physician for an appointment in the next two weeks.
  4. Go to the Emergency Department.



If you guessed 4. Go to the Emergency Department, you are right!

The patient has a Deep Venous Thrombosis (DVT).  Deep venous thrombosis is a condition where a patient develops a blood clot, usually in the leg.  Risk factors include recent surgery, family history of blood clots, oral contraception (birth control pills), sedentary situations (such as lack of activity or airplane travel), and cancer (because cancer can cause increased blood clotting).

Deep venous thrombosis can cause a clot to travel to the lungs, called a pulmonary embolism, and can result in death.

Deep venous thrombosis is diagnosed by an ultrasound of the leg.  Pulmonary embolism is diagnosed by a CT scan of the chest.  The treatment for a DVT is blood thinners.


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