The diagnosis of acute proximal deep vein thrombosis (DVT) can be difficult to make on the basis of clinical findings alone. Since it may be encountered by all clinicians, chiropractors must be aware of the often confusing clinical picture with which it may present. In its early stages patients may present with posterior thigh, calf and groin pain, symptoms that may mimic other types of biomechanical disorders. Because 50% of patients with DVT may develop life threatening thromboembolism, early detection and appropriate referral is crucial. To highlight the clinical presentation of DVT and the phenomenon of “silent embolism” the case of a 58-year-old male presenting to a chiropractic office for assessment and treatment of low back and leg pain is presented. The prevalence, etiology and risk factors associated with its onset are reviewed. Physical examination findings, diagnostic imaging and treatment are discussed. Considerations in the chiropractic management of the post-thrombolytic patient are highlighted.
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