Deep Vein Thrombosis


Blood clots in the legs or Thrombophlebitis

 

  • This occurs when a blood clot obstructs the veins deep in the leg, impeding blood from properly returning to the heart.  Blood and fluid back up, causing swelling, redness, and pain in the leg below the clot.

  • Leg or calf aching
  • Tightness or pain
  • Leg swelling
  • Leg redness
  • Calf tenderness

  • Prolonged bed rest (often after illness or surgery)
  • Long periods when the legs are kept stationary, such as prolonged car or plane rides
  • Birth control pills (smoking with birth control pills increases the risk)
  • Hypercoagulable states (diseases that increase blood clotting), such as protein C and S deficiency and antithrombin III deficiency
  • Cancer

  • Examination: 

  1. Homan's sign (pain in the calf with foot flexion)- there is concern that this may cause the clot to move, so if suspicion for a clot is high, it is not often done
  2. "Cord" may be felt

  • Tests: 

  1. Doppler Ultrasound
  2. Venography (dye injected and X-Rays taken)


  • Leg elevation
  • Heparin intravenously or new low molecular weight Heparin (Lovenox) by injection
  • Coumadin (oral blood thinner) usually taken for 6 months after the clot appears


  • Individuals on bed rest:
    1. Low dose Heparin
    2. Leg elevation
    3. Leg exercises
    4. Pneumatic compression hose
    5. Coumadin (often used in patients who have hip surgery)
    6. Avoid prolonged sitting with travel
    7. Walking for brief periods every 1-2 hours

  • Calf muscle strain
  • Calf injury
  • Cellulitis
  • Ruptured Baker's cyst