A 45-year-old female presents with swelling, warmth, and pain in her right calf and knee that started 2 days after a long trip. Which of the following is the most likely diagnosis, and what should be the next step in management?

A 45-year-old female presents with swelling, warmth, and pain in her right calf and knee that started 2 days after a long trip. Which of the following is the most likely diagnosis, and what should be the next step in management?

• A. Meniscal tear; continue with PT exercises
• B. Acute knee OA flare-up; cryotherapy and STM
• C. DVT; refer the patient to physician
• D. PFPS; recommend anti-inflammatory meds

Answer: (C)

Suspecting a deep venous thrombosis in a leg with swelling, warmth, and pain after a long period of immobilization is the key idea. Prolonged travel slows venous return, increasing clot risk in the deep veins of the leg. A DVT is serious because a piece of clot can travel to the lungs and cause a pulmonary embolism, so it requires urgent medical assessment. The best next step is to refer for urgent medical evaluation, typically with duplex ultrasonography of the leg to confirm a thrombus. If a DVT is found, anticoagulation is started under medical supervision. This approach is chosen over knee-focused diagnoses because the presentation isn’t just a joint problem—it signals a vascular issue with potentially life-threatening consequences.

Suspecting a deep venous thrombosis in a leg with swelling, warmth, and pain after a long period of immobilization is the key idea. Prolonged travel slows venous return, increasing clot risk in the deep veins of the leg. A DVT is serious because a piece of clot can travel to the lungs and cause a pulmonary embolism, so it requires urgent medical assessment.

The best next step is to refer for urgent medical evaluation, typically with duplex ultrasonography of the leg to confirm a thrombus. If a DVT is found, anticoagulation is started under medical supervision. This approach is chosen over knee-focused diagnoses because the presentation isn’t just a joint problem—it signals a vascular issue with potentially life-threatening consequences.