Wai Khoon Ho
Venous thromboembolism (VTE), comprising deep vein thrombosis and pulmonary embolism (PE), is the third commonest vascular disorder in Caucasian populations.1 In Australia, DVT alone (without concomitant PE) affects 52 persons per 100 000 annually.2 Timely management of DVT is important as it is a common cause of morbidity. Thromboses of the deep veins in the upper limbs and ‘unusual sites’, such as mesenteric veins, constitute less than 10% of DVT cases.2 As they are uncommon, this article focuses only on the risks and diagnosis of lower limb DVT.
Venous thromboembolism, comprising deep vein
thrombosis (DVT) and pulmonary embolism, is common in
Australia and is associated with high morbidity.
This article provides a summary of the risk factors for
DVT of the lower limb and discusses the diagnosis of
the condition using a diagnostic algorithm incorporating
clinical assessment, D-dimer testing and imaging studies.
It also briefly reviews the clinical significance of isolated
distal lower limb DVT and superficial vein thrombosis.
Many conditions in the lower limb mimic DVT. Diagnosing
DVT on clinical grounds without objective testing is
unreliable. Patients incorrectly diagnosed as having DVT
may be subjected to unnecessary anticoagulation and its
associated risks of bleeding. In contrast, there is a risk of
thrombus extension and embolisation when DVT is missed
or inappropriately treated.
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