Which presentation suggests a deep vein thrombosis in the leg?

• A. Numbness and tingling without swelling.
• B. Bilateral leg swelling and coldness.
• C. Unilateral leg swelling, warmth, redness, calf tenderness; recent immobilization or surgery.
• D. Bruising on the leg after minor trauma.

Answer: (C)

Unilateral leg swelling with warmth, redness, and calf tenderness after a period of immobilization or recent surgery points to deep vein thrombosis. A clot in a deep leg vein causes venous outflow obstruction, leading to localized swelling and inflammation. The warmth and redness reflect the inflammatory process around the clot, and calf tenderness occurs where the deep veins are most likely involved. The added risk factor of immobilization or recent surgery further increases the chance of clot formation due to slower blood flow and a pro-thrombotic state.

Numbness and tingling without swelling suggests a nerve issue rather than a venous clot. Bilateral swelling and coldness implies a systemic or arterial/vascular problem rather than a focal deep venous thrombosis in one leg. Bruising after minor trauma points to a hematoma or soft-tissue injury, not a venous clot.