Which physical findings are characteristic of deep vein thrombosis in patients with protein S deficiency?

Updated: Jan 03, 2021
  • Author: Mohammad Muhsin Chisti, MD, FACP; Chief Editor: Perumal Thiagarajan, MD  more...
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  • The most common manifestation is venous thrombosis of the lower extremities, whichaccounts for approximately 90% of all events

  • Superficial veins that are obviously thrombosed usually appear distended, firm, and noncompressible (cords), with or without associated redness or pain

  • Superficial thrombophlebitis can be observed in some cases, with or without DVT

  • Suspect DVT if identifying signs of venous obstruction and local inflammation are present on examination

  • The classic presentation of DVT is a triad of calf pain, edema, and pain on dorsiflexion of the foot (ie, Homan sign). However, less than a third of DVT cases exhibit these three findings; physicians observe unilateral leg or calf swelling with mild or moderate pain more often, which suggests DVT; rarely, calf discomfort without swelling is the only sign of DVT

  • Differential diagnoses for DVT include muscle strains and tears, passive swelling of a paralyzed or immobilized limb, Baker cyst, cellulitis, knee trauma or derangement, lymphatic obstruction, and postphlebitic syndrome

  • In postphlebitic syndrome, chronic swelling and pain are present in the limb, and the occurrence of a new venous thrombosis is often impossible to assess without Doppler or venography.

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