After taking vitals (concern for PE) and observing whether the patient is in any obvious pain. Then examine the patient in the horizontal position with knees slightly flexed.
- Inspect for swelling, discoloration (red, white, cyanotic) & collateral superficial veins (measure for swelling with a measuring tape if appropriate).
- Palpate for temperature difference, leg tenderness and pitting edema.
The clinical signs for DVT are highly variable and non-specific.
Some physical findings are used in modern day clinical scores (e.g., Wells score):
- Swelling
- Pitting edema
- Presence of collateral veins
It is important to rule out phlegmasia alba dolens and cerulea alba dolens. These are rare complications that can lead to venous gangrene.