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Point-Of-Care Ultrasound Screening for Proximal Lower Extremity Deep Venous Thrombosis
06:45

Point-Of-Care Ultrasound Screening for Proximal Lower Extremity Deep Venous Thrombosis

Published on: February 10, 2023

Prevalence of concurrent deep vein thrombosis in patients with lower limb cellulitis: a prospective cohort study

Michael J Maze1, Sean Skea, Alan Pithie

  • 1Department of Infectious Diseases, Christchurch Hospital, Christchurch, 8002, New Zealand. Michael.Maze@cdhb.health.nz

BMC Infectious Diseases
|March 21, 2013
PubMed

Insights

Deep vein thrombosis (DVT) rarely occurs with lower limb cellulitis. The Wells score overestimates DVT risk in these patients, suggesting DVT investigation is often unnecessary unless a hypercoagulable state exists.

Area of Science:

  • Vascular Medicine
  • Infectious Diseases
  • Diagnostic Accuracy

Background:

  • Lower limb cellulitis and deep vein thrombosis (DVT) present with overlapping clinical features, leading to frequent DVT investigations in cellulitis patients.
  • The actual prevalence of concurrent DVT in patients with lower limb cellulitis remains uncertain.
  • Clinical assessment tools like the Wells criteria are commonly used but their utility in this specific patient group needs evaluation.

Purpose of the Study:

  • To determine the prevalence of deep vein thrombosis (DVT) in patients presenting with lower limb cellulitis.
  • To assess the diagnostic utility of the Wells criteria in identifying DVT in this patient population.
  • To evaluate the necessity of DVT investigations in patients with lower limb cellulitis.

Main Methods:

  • Prospective assessment of 200 patients admitted with lower limb cellulitis.
  • Application of the Wells criteria for DVT risk stratification.
  • Investigation using D-dimer testing and ultrasonography of the affected leg.

Main Results:

  • Only 1 patient (0.5%) was diagnosed with ipsilateral DVT.
  • An additional 2 patients (1%) had non-ipsilateral venous thromboembolism (VTE).
  • The Wells score indicated a high risk for 20% of patients, but diagnostic yield was very low.

Conclusions:

  • Deep vein thrombosis (DVT) is uncommon in patients with lower limb cellulitis.
  • The Wells score significantly overestimates DVT likelihood due to overlapping symptoms.
  • Routine DVT investigation in cellulitis patients is generally not warranted without a hypercoagulable state.
Abstract

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