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Will Increase In INR Cause Pain In Thigh?
My INR is 4.8 and I have not changed my diet and I haven t taken any new prescribed or OTC medication. My target level is 2.5-3.5 and I take a daily dose of 3.5mg. I am not sick with the flu, cold, etc. I have however, been dealing with severe unexplained pain in my thigh for the last few days. Even with the pain I have not resorted to taking OTC tylenol or any type of pain medication. (I have a hard enough time taking my prescribed medication, I hate taking medication). Could this pain possibly be related to my slightly elevated INR? Also, I did have an ultrasound on my leg a couple of days ago and there was no indication of a clot. I do have a history of diabetes, heart disease and a PE, and I am not on the coumadin for life because of Antiphospholipid Antibody Syndrome.
posted on
Fri, 14 Mar 2014
Medically reviewed by
Ask A Doctor - 24x7 Medical Review Team
Sat, 19 Sep 2020
Answered on
Tue, 22 Sep 2020
Last reviewed on
Hello,
Whenever a patient has an elevated INR and pain in an extremity I worry about a hematoma forming causing the discomfort, especially if there has been any trauma to the area. You mentioned that you had an ultrasound, did they just look at the blood vessels do you know, or did they also look at the 'soft tissue' where the pain was located? Sometimes a hematoma can be deeper in the muscle layer and not obvious to simple visual inspection but the ultrasound if it was directed at that specific area would have indicated the blood collection.
I have had numerous patients that had hematomas like this that even the ultrasound didn't show and were picked up on on a CT scan. If you can inform me of the specific results of the ultrasound scan or find out if the scan did in fact look at the area in question that would be helpful. The physician who ordered the test would also be able to tell you which study was ordered and what they were looking for. A scan looking for blood clots doesn't always pick up hematomas.
Take care. Hope I have answered your question. Let me know if I can assist you further.
Regards,
Dr. David Girardi, Internal Medicine Specialist
Whenever a patient has an elevated INR and pain in an extremity I worry about a hematoma forming causing the discomfort, especially if there has been any trauma to the area. You mentioned that you had an ultrasound, did they just look at the blood vessels do you know, or did they also look at the 'soft tissue' where the pain was located? Sometimes a hematoma can be deeper in the muscle layer and not obvious to simple visual inspection but the ultrasound if it was directed at that specific area would have indicated the blood collection.
I have had numerous patients that had hematomas like this that even the ultrasound didn't show and were picked up on on a CT scan. If you can inform me of the specific results of the ultrasound scan or find out if the scan did in fact look at the area in question that would be helpful. The physician who ordered the test would also be able to tell you which study was ordered and what they were looking for. A scan looking for blood clots doesn't always pick up hematomas.
Take care. Hope I have answered your question. Let me know if I can assist you further.
Regards,
Dr. David Girardi, Internal Medicine Specialist
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