Diagnosis of deep venous thrombosis

Although deep venous thrombosis (DVT) is often considered an elusive disease that is difficult to recognize clinically, important clinical clues and properly ordered imaging tests can reliably detect or exclude this condition. This article will provide a practical approach to recognizing clinical settings in which DVT should be suspected, suggesting a focused history and physical examination and outlining optimal strategies for test ordering. This information will help ensure that patients with DVT are identified rapidly and, conversely, that those without DVT will receive reassurance or specific treatment for the medical problem that mimics it. Once DVT is suspected, a workup can proceed rapidly and accurately to resolve the diagnostic issue.