Venous Thromboembolism. Deep Vein Thrombosis (DVT) Diagnosis Algorithm.

[DVT confirmed - see Treatment algorithm]

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Source: Institute for Clinical Systems Improvement (ICSI). Venous thromboembolism. Bloomington (MN): Institute for Clinical Systems Improvement (ICSI); 2007 Jun. 91 p. Venous Thromboembolism Deep Vein Thrombosis (DVT) Diagnosis Algorithm Leg symptoms/clinical suspicion of DVT. A A = Annotation Determine clinical pretest probability. A Low clinical pretest probability. A Moderate/high clinical pretest probability. A D-dimer test. A DVT excluded - out of guideline. A Result positive? Perform duplex ultrasound (with compression). A D-dimer test for moderate/high pretest. A Result positive? DVT confirmed - see Treatment algorithm. A Result positive? Follow-up studies/second duplex ultrasound (3-7 days) or venography. A Clinical Pretest Probability (CPTP - Wells DVT Score) - See Appendix A. Active cancer (on treatment for last 6 months or palliative). 1. Paralysis, paresis or plaster immobilization of lower limb. 1. Immobilization previous 4 days. 1. Entire leg swollen. 1. Calf swollen by more than 3 cm. 1. Pitting edema. 1. Collateral superficial veins (non-varicose). 1. Probable alternative diagnosis. -2. High DVT Risk = 3 plus. Moderate DVT Risk = 1-2. Low DVT Risk = less than 1. If both legs are symptomatic, score the more severe leg. All copyrights are reserved by the Institute for Clinical Systems Improvement, Inc.