Virtually all rehabilitation inpatients are in high-risk groups.
Postphlebitic syndrome can arise in a limb after DVT, if the patient is not given compression hose.
Diagnosis is difficult. Examination is unreliable. Sudden onset calf pain and/or unilateral lower limb calf swelling is the classic presentation of lower extremity DVT. For upper limb DVT, sudden swelling of the arm should trigger investigation, particularly if a central venous access device is or has been in place. For PE, dyspnea is usually the presenting symptom.
Some functional loss may occur because of edema (DVT) or because of pulmonary symptoms (PE).
Some have advocated the use of D-dimer to screen symptomatic patients before ordering an ultrasound (US). This screen may have some utility in the outpatient setting in patients at low risk; however, in postoperative patients, it is of little benefit because the positive predictive value is low, and false positives are frequent.
Undiagnosed PE is one of the most common reasons for malpractice suits against physiatrists.