ACUTE

The Road to Diagnosis

Any surgery or trauma?

Reflex Sympathetic Dystrophy

ACUTE

History of cancer?

<72 hours

Examine lymph nodes,

Pelvic/rectal exam,

CT abdo/pelvic

Likelihood of DVT

Chronic

Chronic Venous Insufficiency

>72 hours

Low

1 point or less

High

D-Dimer Assay

2 points or more

Normal

Elevated

>500ng/ml

<500ng/ml

Still confused?

Duplex Ultrasound

Other aetiologies:

Musculoskeletal Problems

• Cellulitis
• Malignancy
• Allergic reaction

• Ruptured medial head of gastrocnemius

Duplex Ultrasound

+ evaluate systemic cause

• Ruptured Baker's cyst

DVT

MRV

Magnetic Resonance Venography to evaluate pelvic or distal DVT (if suspicion is high)