Deep venous thrombosis is a diagnosis that should be considered in any patient who presents with a swollen or painful leg. Clinical examination alone has low sensitivity and specificity for detecting patients with clots, and in recent years a diagnostic pathway has been devised that is more effective. This involves integration of three modalities: clinical assessment, D-dimer analysis and ultrasound. The management of a patient found to have a deep venous thrombosis includes immediate treatment but also the consideration of risk factors, family history, need for thrombophilia testing, duration of treatment and the prevention of postthrombotic syndrome.
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