Question

A 60-year-old man presents with a swollen, painful left calf of 2 days’ duration following a long-haul flight. He has no shortness of breath or chest pain. On examination, his left calf is oedematous and tender with a 3 cm difference in circumference compared with the right. He has no active cancer or recent surgery. His Wells score suggests a likely deep vein thrombosis. Immediate proximal leg vein ultrasound is not available. What is the most appropriate next step?

Accepted Answer

Start a direct oral anticoagulant and arrange ultrasound within 24 hours

Answer

Discharge with reassurance and review if symptoms worsen

Answer

Start Aspirin and arrange ultrasound within 2 weeks

Answer

Arrange a D-dimer test and await the result before treatment

Answer

Admit for intravenous heparin and echocardiography

Practice question