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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)

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