What Causes Persistent Pain In The Legs?

Posted on Sat, 18 Mar 2017

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Sat, 18 Mar 2017 Answered on

Sat, 8 Apr 2017 Last reviewed on

Question : I recently have been experiencing pain in my legs. Mainly my left leg. I am a 27 year old male, and had my appendix removed 6 weeks ago. I am overweight, 6 foot 275, and a smoker. About a half a pack of day. I was concerned for a possible DVT and I went to the emergency room where they checked me over, found no swelling or redness, and gave me a D Dimer which came back negative. How likely is it that I still may have a DVT. Lately my anxiety has been through the roof and I have had slight chest pains but I have chalked those up to to the anxiety.

Answered by Dr. Klarida Papaqako (4 hours later)

Brief Answer:
Some symptoms that indicate DVT

Detailed Answer:
Hello,
Thank you for using Healthcaremagic to post your question.
I read it carefully and I understand your concern.

Somo symptoms that may indicate that you may have DVT are:
- Pain in the calf or the upper leg but not in the joints/bones.
- Swelling more then 2 cm comparing with the other side. It is very unlikely that a DVT happens in both sides at the same time.
- Sometimes presence of varicose veins or any redness because of the superficial veins swelling as well.
- Past history of DVT
- Obesity, smoking and having a job where you don't move for many hours, makes it more prone to happen.

The best way to tell for sure if a DVT is happening, is to do an ultrasound of the veins of the legs.

Hope this is helpful.
Let me know if you have other questions or concerns.

Regards,
Dr.Papaqako

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Klarida Papaqako (43 minutes later)

I dont have a family history of DVT actually bo one in my family has to be exact. Im basically wondering how accurate is the D Dimer test in diagnosing it? It came back negative and the doctor didnt seem too concerned... still scared tho

Answered by Dr. Klarida Papaqako (1 hour later)

Brief Answer:
Yes, D-dimer is highly sensitive

Detailed Answer:
Hello,

Thank you for the follow-up question.

Here is how we think to determine the diagnoses of DVT:
- In patient with low clinical pretest probability of DVT the first test we do, which is highly sensitive is D-dimer.
- negative high-sensitivity D-dimer can rule out DVT
- D-dimer may not be sufficient to rule out DVT in older patients or patients with comorbidity or long duration of symptoms.
- If positive D-dimer, we consider lower extremity duplex ultrasound with compression of proximal veins
- In patient with moderate clinical pretest probability of DVT guidelines for suggested initial test vary - either highly sensitive D-dimer or compression ultrasound

Hope this helps to reassure you.

Kind Regards,
Dr.Papaqako

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Above answer was peer-reviewed by : Dr. Kampana