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
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.
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