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What is your dx?

Discussion in 'Case Studies' started by DR.G, Sep 6, 2011.

  1. DR.G

    DR.G Super Moderator

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    [​IMG]

    Complaint
    A 28-year-old woman has a painful and swollen right leg. She says her symptoms began 2 days ago, as she was getting off a plane after a 13-hour flight from overseas. Her symptoms have increased gradually since that time. She denies left leg complaints, shortness of breath, or chest pain.
    History
    Past medical history is insignificant and the patient's only regular medication is oral contraceptive pills. The patient smokes 1 pack of cigarettes per day.
    Physical Exam
    The patient has a low-grade fever (101.3 °F [39 °C]). She is obese but in no acute distress. The right leg below the knee is edematous, enlarged, mildly erythematous, and warmer to the touch than the left leg. With the knee flexed, forceful dorsiflexion at the ankle causes severe calf pain. The rest of the physical exam is normal.
    Tests
    Hemoglobin: 13 mg/dL (normal 12-16)
    White blood cell count: 8400/μL (normal 4500-11,000)
    Platelets: 330,000/μL (normal 150,000-400,000)
    Creatinine: 0.9 mg/dL (normal 0.6-1.5)
    Sodium: 142 mEq/L (normal 135-145)
    D-Dimer: positive
     

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  2. Rocket Queen

    Rocket Queen Super Moderator

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    Deep vein thrombosis
     

  3. Kebo Gere

    Kebo Gere Well-Known Member

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    Dvt
     

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  4. Luis

    Luis Active member

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    deep vein thrombosis
     

  5. Javed

    Javed Famous Member

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    Deep vein thrombosis (DVT)​
     

  6. dilki punchihewa

    dilki punchihewa Active member

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    Deep vein thrombosis
     

  7. raviteja madduri

    raviteja madduri Young Member

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    deep vein thrombosis..
     

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    Mahdi Young Member

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    dvt
     

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    fathima Young Member

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    fahime jamshidi Young Member

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    Melissa Well-Known Member

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    dvt
     

  12. stepha

    stepha Well-Known Member

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    trio wicaksono Young Member

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    Deep Vein Trombosis
     

  14. jhonnylim1800

    jhonnylim1800 Young Member

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    Deep vein thrombosis
     

  15. Dr Abhishek Kumar

    Dr Abhishek Kumar Well-Known Member

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    Dorinka Nel Active member

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    Deep vein trombosis. Risk factors: oral contraceptives, smoking, immobility in-flight. Symptoms: painful swollen leg temporal relationship to flight, Signs: positive Homan sign (dangerous to do as it can dislodged the clot), warm and tender. Lab tests: + D-dimer. Pt needs Duplex doppler to confirm diagnosis. Anticoagulate immediately.
     

  17. Maher Mufid El-Khalidi

    Maher Mufid El-Khalidi Bronze Member

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    DVT , I agree with my previous colleague
     

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