An older woman with pain and swelling of left leg
AbstractDisplayed is the photograph of the lower limbs of a 58-yearold lady who complained of pain and swelling of her left leg.Examination revealed tenderness in her left leg especiallyaround her calf area which was warm to touch. She wasafebrile and her vital signs were within normal limits. She wasrecently diagnosed with cervical carcinoma and underwent atotal hysterectomy 2 weeks ago. Her full blood count wasnormal. (copied from article)
Qaseem A, Snow V, Barry P, et al. Current diagnosis of venous thromboembolism in primary care: a clinical practice guideline from the American Academy of Family Physicians and the American College of Physicians. Ann Intern Med. 2007;146(6):454-8.
Tovey C, Wyatt S. Diagnosis, investigation, and management of deep vein thrombosis: BMJ. 2003;326(7400):1180-4.
Wells PS, Owen C, Doucette S, et al. Does this patient have deep vein thrombosis? JAMA. 2006;295(2):199-207.
Ebell MH. Evaluation of the patient with suspected deep vein thrombosis. J Fam Pract. 2001;50(2):167-71.
Keeling DM, Mackie IJ, Moody A, et al. The diagnosis of deep vein thrombosis in symptomatic outpatients and the potential for clinical assessment and D-dimer assays to reduce the need for diagnostic imaging. Br J Haematol. 2004;124(1):15-25.
Aschwanden M, Labs KH, Jeanneret C, et al. The value of rapid D-dimer testing combined with structured clinical evaluation for the diagnosis of deep vein thrombosis. J Vasc Surg. 1999;30(5):929-35.
Kearon C, Ginsberg JS, Douketis J, et al. Management of suspected deep venous thrombosis in outpatients by using clinical assessment and D-dimer testing. Ann Intern Med. 2001;135(2):108-11.
Kraaijenhagen RA, Lensing AW, Wallis JW, et al. Diagnostic management of venous thromboembolism. Baillières Clin Haematol. 1998;11(3):541-86.
de Valois JC, van Schaik CC, Verzijlbergen F, et al. Contrast venography: from gold standard to “golden backup” in clinically suspected deep vein thrombosis. Eur J Radiol. 1990;11(2):131-7.
Brandjes DP, Buller HR, Heijboer H, et al. Randomised trial of effect of compression stockings in patients with symptomatic proximal-vein thrombosis. Lancet. 1997;349(9054):759-62.