Lower leg swelling is one of the physical findings of deep vein thrombosis (DVT). However, limb swelling is a frequent complaint and lacks in specificity. Between April 2011 and March 2014, a total of 597 consecutive patients with swollen leg underwent duplex sonography (221 men and 376 women; mean age 72.5 ± 12.1 years). Patients were divided into a bilateral swelling group and a unilateral swelling group, each was subdivided into two groups (with or without DVT). Furthermore, we investigated other thrombotic risk factors, location of thrombus, and D-dimer level. DVT was more frequent in females. Prevalence of DVT in unilateral swelling patients was significantly higher than those in bilateral swelling patients. D-dimer level was higher in patients with proximal DVT compared with those with calf DVT. In patients with swollen leg, we could suggest that the diagnosis of DVT should be considered based on laterality, D-dimer level, and thrombotic risk factors.

View full abstract

A 77-year-old woman presented with left upper limb weakness. Positron emission tomography-computed tomography (PET-CT) revealed fludeoxyglucose (FDG) accumulation in bilateral subclavian arteries. Ultrasonography demonstrated the halo sign in the temporal artery. Biopsy led to a diagnosis of giant cell arteritis. The left radial artery could not be palpated, and ultrasonography revealed bilateral subclavian artery stenosis. We performed balloon angioplasty to bilateral subclavian arteries, and the radial artery became readily palpable. In this case, ultrasonography aided in the diagnosis and determination of the extent of the lesions.

View full abstract