Sudden onset swelling and pain in limbs should always be
attended to by a doctor. A number of
things can cause swelling, including insect bites, bruises, muscle injury
and, most concerning, a deep vein thrombosis (DVT). DVT is the medical term for
when a blood clot forms in the venous blood vessels of the limbs. This
condition can be potentially fatal and always requires medical attention.
Blood clots can form anywhere in the body, but are more
commonly found in the blood vessels of the lower limbs and pelvis. The legs have
two venous "systems", i.e. deep veins and superficial veins. When blood
clots form in the deep veins, they can potentially dislodged fully or partially
and end up in the lung where the can cause pulmonary embolism and death.
Read: DVT a danger during travel
A number of factors can cause a DVT. These include
immobility for prolonged periods of time, surgeries (like hip replacements,
which will also immobilise the patient), pregnancy, varicose veins, cancers and
paralysis. Other factors increasing the risk for developing DVT's include:
smoking, long haul flights and the use of birth control methods like oral
Symptoms and signs
Sudden onset pain, swelling, tenderness or discomfort in
a limb are usually among the first symptoms. Swelling of the limb is usually
unilateral (one side only). Redness and a marked temperature difference between
the two limbs are important signs. The pain is usually intense and the
patient can often not carry weight on the affected leg.
Read: Pain Centre
In the case of possible pulmonary embolism, sudden
shortness of breath, chest pain and severe lightheadedness should be looked out
When clinical suspicion arises that a DVT might be the
cause of the symptoms and signs, a doctor will do blood tests like D-Dimer
to check for possible clotting problems in your blood. Ultrasound of the veins
of your legs and MRI's will also be performed.
DVTs are treated with blood thinners (like warfarin,
xeralto or pradaxa). These will prevent the clot from growing or new clots from
Occasionally surgery is needed where the clot might be
removed, or a filter is placed in the vena cava to prevent small pieces of clot
that might break-off travelling to the lungs.
Mrs L had a couple of risk factors for development of
DVT's: she is smoker, she works as an air hostess causing her to sit for long
periods of time, and she also uses a birth control pill. Based on the
supplied information, it is unlikely the clot has as yet caused any other problems.
NOTE: Health24's on-site GP Dr Owen Wiese reveals
new cases on Thursdays. The answer is posted with the story on Mondays,
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Image: Painful lower leg from Shutterstock
Dr. Owen J. Wiese is Health24's resident doctor. After graduating from Stellenbosch University with additional qualifications in biochemistry and physiology he developed a keen interest in providing medical information through the media.