Share your insights

Help us by sharing what content you've recieved in your exams

DVT Examination


  • Wash hands
  • Introduce self
  • Ask Patientโ€™s name, DOB and what they like to be called
  • Explain examination and obtain consent
  • Expose the patientโ€™s legs. Check for any pain in legs. 

General inspection

  • Look at the patient from the end of the bed
    • Are they well/unwell?
    • Any breathlessness?
    • Are they in pain/discomfort?
  • Consider DVT risks
    • Signs of malignancy (e.g. cachexia)
    • Signs of immobility (e.g. walking aids)
    • Signs of recent surgery or trauma, pregnancy 
  • Look around the bed: medicines etc.

Leg inspection

Inspect with the patient standing:

  • Look at the patient’s skin: are there any colour changes?
  • Ankle/leg swelling (unilateral may indicate DVT; bilateral may indicate oedema, e.g. in heart failure)
  • Venous insufficiency signs
    • Venous eczema and haemosiderin deposits (red-brown patches)
    • Lipodermatosclerosis (โ€˜inverted champagne bottle legโ€™; increased venous pressure causes inflammatory cells to fibrose subcutaneous tissue)
    • Venous ulcers
    • Note any venous dilatation and tortuosity (varicose veins)
Stages of venous insufficiency


Palpate with the patient supine:

  • Temperature: feel for temperature differences between legs using the back of your hand (minimum three places each side) 
  • Tenderness: palpate for calf tenderness with knee slightly flexed (squeeze near ankle and then up calves while watching face)
  • Pitting oedema: if present, establish how far oedema extends (and also check JVP)
  • Calf diameters: measure circumference 10 cm below tibial tuberosity (>3cm difference = significant)
  • Palpate pulses

To complete 

  • Thank patient and restore clothing
  • โ€˜To complete my examination, I would perform full cardiovascular and respiratory examinations. I would review the patientโ€™s observations, including oxygen saturations and respiratory rate. If these are abnormal, I would consider the possibility of a pulmonary embolism.โ€™
  • Summarise and suggest further investigations you would consider after a full history

Why don’t you test your knowledge?

How would you investigate a patient with a suspected DVT? Consider the Wells score in your answer.

Oops! This section is restricted to members. Click here to signup!

Name five risk factors for venous thromboembolism

Oops! This section is restricted to members. Click here to signup!

What is Virchow’s Triad?

Oops! This section is restricted to members. Click here to signup!

No comments yet ๐Ÿ˜‰

Leave a Reply