The chance of having a deep vein thrombosis can be estimated by considering clinical findings in the affected patient.
Major Points (Table 1, Ginsberg, 1996):
(1) active cancer (ongoing therapy, palliative therapy, treatment within prior 6 months)
(2) paralysis, paresis or recent cast immobilization of the leg or foot
(3) recent bed rest for > 3 days, major surgery within past 4 weeks, or both
(4) localized tenderness along the distribution of the deep venous system
(5) swelling of thigh and calf (should be measured)
(6) swelling of calf to 3 cm greater than that of the asymptomatic side (measured 10 cm below tibial tuberosity)
(7) strong family history of deep-vein thrombosis (>= 2 first degree relatives with a history of deep-vein thrombosis)
Minor Points (Table 1, Ginsberg, 1996):
(1) history of recent trauma (within past 60 days) to the symptomatic leg
(2) pitting edema (in symptomatic leg only)
(3) dilated superficial veins (non-varicose) in symptomatic leg only
(4) hospitalization within previous 6 months
(5) erythema
In patients with symptoms in both legs, the more symptomatic leg is used.
Interpretation
|
Number of Major Points |
Number of Minor Points |
Alternative Diagnosis? |
Probability |
|
>= 3 |
>= 0 |
No |
high |
|
2 |
>= 2 |
No |
high |
|
>= 3 |
>= 0 |
Yes |
intermediate |
|
2 |
>= 2 |
Yes |
intermediate |
|
2 |
0 or 1 |
No |
intermediate |
|
2 |
0 or 1 |
Yes |
intermediate |
|
1 |
>= 2 |
Yes |
low |
|
1 |
>= 1 |
No |
low |
|
0 |
>= 3 |
Yes |
low |
|
0 |
>= 2 |
No |
low |
|
1 |
0 or 1 |
Yes |
very low |
|
1 |
0 |
No |
very low |
|
0 |
2 |
Yes |
very low |
|
0 |
1 |
No |
very low |
Specialty: Hematology Oncology, Clinical Laboratory
ICD-10: ,
