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,
or you can get it in our Daily Tip – sign up here.
Previously on What's Your Diagnosis?
What's your diagnosis? - Case 1: vomiting and weight loss
What's your diagnosis? - Case 2: eye pain
What's your diagnosis? - Case 3: strange behaviour and a bullet in the back
What's your diagnosis? - Case 4: seeing odd things
What's your diagnosis? - Case 5: mysterious lungs
What's your diagnosis? - Case 6: runner with seizures
What's your diagnosis? - Case 7: swollen knee
What's your diagnosis? - Case 8: bloody semen
What's your diagnosis? - Case 9: confusing neurological signs
What's your diagnosis? - Case 10: diabetic teenager with unusual signs and symptoms
What's your diagnosis? - Case 11: bruising with no apparent reason
What's your diagnosis? - Case 12: severe tummy pain
What's your diagnosis? - Case 13: severe sore throat
What's your diagnosis? - Case 14: abdominal pain and swelling
What's your diagnosis? - Case 15: the world is spinning
What's your diagnosis? - Case 16: numbness in forearm
What's your diagnosis? - Case 17: burning urine
What's your diagnosis? - Case 18: boy with persistent fever
What's your diagnosis? – Case 19: lady who can't lose weight
What's your diagnosis? – Case 20: chest pain next to breastbone
What's your diagnosis? – Case 21: burning sensation in vagina
What's your diagnosis? – Case 22: vomiting and headachesWhat's your diagnosis? – Case 23: frequent urination
Image: Painful lower leg from Shutterstock