Deep vein thrombosis
The most common type of venous thromboembolism is deep vein thrombosis, which occurs most frequently in veins deep within the muscles of the leg and pelvis.
Diagnosis of DVT
Signs and symptoms
Clinical probability scores
Wells score for prediction of DVT.45
|DVT, deep vein thrombosis.|
|Active cancer (treatment ongoing or within previous 6 months or palliative)||1|
|Paralysis, paresis or recent plaster immobilization of lower extremities||1|
|Recently bedridden for more than 3 days or major surgery within 4 weeks||1|
|Localised tenderness along distribution of the deep vein system||1|
|Entire leg swollen||1|
|Calf swelling by more than 3 cm when compared with asymptomatic leg||1|
|Collateral superficial veins||1|
|Alternative diagnosis as likely or greater than that of DVT||-2|
Computed tomography venography
Magnetic resonance imaging
Risk factors for recurrence
- Initial proximal (rather than distal) DVT
- Male gender
- Elevated D-dimer concentration
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- Venous thromboembolism
- A condition in which a blood clot (thrombus) forms in a vein, which in some cases then breaks free and enters the circulation as an embolus, finally lodging in and completely obstructing a blood vessel, e.g., in lungs causing a PE. The term encompasses both DVT and PE.
- The prevention of a disease or pathological condition.
- Post-thrombotic syndrome
- A syndrome that can follow a vascular thrombosis. Clinical signs and symptoms of this syndrome include chronic pain, swelling, oedema, discolouration, and in severe cases, venous ulceration. It is likely that valvular incompetence is associated with the clinical manifestations of post-thrombotic syndrome.
- Compression ultrasonography
- Ultrasonography scanning is widely used in medicine as an effective method of imaging the soft tissues of the body. Compression ultrasonography combines real-time imaging of the deep veins with venous compression to diagnose DVT. It has become the noninvasive method of choice for DVT diagnosis on the basis of its excellent accuracy and wide availability.
- The presence of abnormally large amounts of fluid in the intercellular tissue spaces of the body, usually used to describe demonstrable accumulation of excessive fluid in subcutaneous tissues.
- An X-ray of the veins performed by first injecting a radiopaque contrast (shows up on X-ray) into the vein in question and then taking a conventional X-ray. Used to demonstrate blockage of a vein. Commonly used in the lower extremities to diagnose DVT.
- Computed tomography
- Also know as CAT scan. A radiographic technique that uses a computer to assimilate multiple X-ray images into a two-dimensional cross-sectional image.
- Angiography is imaging of the blood vessels using X-rays or magnetic resonance tomography. The vessels are visualised by injecting contrast medium into a vein. Angiography is used to diagnose disorders of the blood vessels.
- The primary end product of the coagulation cascade. Fibrin links itself into strands to form a net. This net traps blood cells and tightens itself through cross-linkages, resulting in a dense blood clot.
- A component (enzyme) of the fibrinolytic system that breaks fibrin into small pieces.
- Factor II, also called prothrombin, is converted into thrombin as part of the coagulation cascade.
- Coagulation factors
- Group of plasma protein substances (Factor I to XIII) contained in the plasma, which act together to bring about blood coagulation.