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
|
