The initial assessment of a swollen arm or leg begins with the health care professional taking a patient history and physical exam. The diagnosis of superficial phlebitis is often made clinically and no further tests are needed.
If there is concern about deep vein thrombosis (DVT), further tests may be ordered.
D-dimer is a chemical that is released by blood clots as they begin to disintegrate. If this blood test is normal, then a blood clot is not present. Unfortunately, the test does not tell the doctor the location where a blood clot might be. For instance, it will be positive in people with a bruise or those who have recently had surgery. This blood test needs to be ordered only when there is a low risk of DVT being present. A positive test usually requires that some imaging test of the arm or leg be ordered to look for a potential blood clot.
Ultrasound can detect clots or blockage of blood flow, especially in larger, more proximal (upper leg) veins. A small hand-held instrument (probe) is pressed against the patient's skin to help identify blood clots and the location of the obstruction. This is a non-invasive test which is relatively painless.
Sometimes the ultrasound test cannot adequately "see" the veins and determine whether a clot is present. Venography may be required in which dye is injected directly into the vein and X-rays are taken to evaluate the vein.
Medically Reviewed by a Doctor on 11/3/2014
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