Friday, January 15, 2010

Well’s Criteria for DVT

The Score

  1. Active cancer (treatment within last 6 months or palliative) -- 1 point
  2. Calf swelling >3 cm compared to other calf (measured 10 cm below tibial tuberosity) -- 1 point
  3. Collateral superficial veins (non-varicose) -- 1 point
  4. Pitting edema (confined to symptomatic leg) -- 1 point
  5. Swelling of entire leg - 1 point
  6. Localized pain along distribution of deep venous system—1 point
  7. Paralysis, paresis, or recent cast immobilization of lower extremities—1 point
  8. Recently bedridden > 3 days, or major surgery requiring regional or general anesthetic in past 4 weeks—1 point
  9. Alternative diagnosis at least as likely—Subtract 2 points
Possible score -2 to 8

Interpretation

Score of 2 or higher - deep vein thrombosis is likely. Consider imaging the leg veins.
Score of less than 2 - deep vein thrombosis is unlikely. Consider blood test such as d-dimer test to further rule out deep vein thrombosis.

References

  • http://en.wikipedia.org/wiki/Deep_vein_thrombosis
  • http://emedicine.medscape.com/article/758140-overview

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