Erring on the side of DVT

We’ve all been diagnosing swollen tender calves since early in our medical school years, but the art is not always as straightforward as it appears.

Tamara’s surgery for Achilles Insertional tendonopathy was successful, so when she limped in wearing her foot to knee plaster with her face contorted with agony, I smelt a rat. The tips of her toes were only just visible and looked normal, so a plaster removal was performed. The calf was not swollen as it had been compressed in a plaster but her distal toes were. Tamara had a DVT which would have gone unnoticed in an encasing plaster – an easy trap to