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Clinical Presentation

The signs and symptoms of DVT are varied and depend on the severity. Generally DVTs can cause pain, swelling, tenderness, skin discolouration and increased warmth of the affected area. The signs and symptoms of PE are nonspecific and can include sudden chest pain, dyspnea, tachypnea, hemoptysis, and loss of consciousness (fainting), which often leads to difficulties with diagnosis. Several methods and techniques are currently used for diagnosis.

Although the various methods of DVT detection will be discussed, it is important for health care professionals, patients, family members and caregivers to be educated in the early signs and symptoms. Expert consensus, as noted by the PVA Consortium of Spinal Cord Medicine (2005) guideline for the prevention of thromboembolism, suggests that all extremities should be inspected twice daily for an increase in the calf or thigh venous pattern or circumference, low-grade fever of unknown origin and/or pain, tenderness, or heaviness of an affected extremity. Since patients can sometimes be asymptomatic, it is also suggested that health care providers, including family and caregivers, be familiarized with risk factors such as lower limb fractures, dehydration, obesity, age, malignancy, congestive heart failure, estrogen therapy, pregnancy, and a history of thrombosis.

Another measure, considered by expert consensus to be important and preventative, is the routine practice of active and passive range of motion exercises. Mobilization and movement of the extremities (with careful consideration of spinal stability in the acute phase) should be essential in the prevention of DVT after a SCI.