https://doi.org/10.4081/reumatismo.2025.1828

Prevalence of musculoskeletal disorders in patients referred for suspected deep vein thrombosis: insights from a rheumatologist-led clinic

Early Access
Published: March 10 2025
Deep vein thrombosis, ultrasound, musculoskeletal disorders
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Authors

Nikoletta Svendsen
nikoletta.svendsen@rsyd.dk
https://orcid.org/0009-0007-1661-6896
Department of Rheumatology, Esbjerg Hospital – University Hospital of Southern Denmark, Esbjerg; Department of Regional Health Research, University of Southern Denmark, Esbjerg, Denmark.
Philip Rask Lage-Hansen
https://orcid.org/0000-0002-1449-254X
Department of Rheumatology, Esbjerg Hospital – University Hospital of Southern Denmark, Esbjerg; Department of Regional Health Research, University of Southern Denmark, Esbjerg, Denmark.
Stavros Chrysidis
https://orcid.org/0000-0001-8583-6517
Department of Rheumatology, Esbjerg Hospital – University Hospital of Southern Denmark, Esbjerg; Department of Regional Health Research, University of Southern Denmark, Esbjerg, Denmark.

Objective. To assess the frequency of deep vein thrombosis (DVT) and alternative diagnoses in patients with suspected DVT when evaluated by a rheumatologist. Secondly, to describe the distribution of different diagnoses across three Wells score categories (low, moderate, and high).

Methods. This is an observational study of patients evaluated at a DVT Clinic for suspected DVT, with a rheumatologist-supervised evaluation, performing ultrasound scans on the affected limbs and assessing their results. The obtained diagnoses were noted along with the initial Wells scores performed by the rheumatologist.

Results. 649 patients were included. DVT was confirmed in 119/649 (18.3%) cases, with musculoskeletal (MSK) disorders, particularly arthritis and knee-related conditions, being the most common alternative diagnoses (166/649, 25.6%). 288/649 (44.4%) patients did not receive a definitive diagnosis. Higher Wells scores were more common in confirmed DVT cases, while patients with MSK disorders generally had lower Wells scores, likely due to clinical assessments that identified alternative diagnoses early.

Conclusions. MSK disorders frequently present with symptoms mimicking DVT, underscoring the value of rheumatologist-led evaluations in suspected DVT cases. Further research is needed to refine diagnostic approaches for patients with DVT-like symptoms, particularly regarding the role of MSK expertise in both physical and ultrasound assessments.

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Europe PMC
Wolf S, Barco S, Di Nisio M, Mahan CE, Christodoulou KC, Ter Haar S, et al. Epidemiology of deep vein thrombosis. Vasa 2024; 53: 298-307. DOI: https://doi.org/10.1024/0301-1526/a001145
Duffet L. Deep venous thrombosis. Ann Intern Med 2022; 175: ITC129-44. DOI: https://doi.org/10.7326/AITC202209200
Schellong S, Ageno W, Casella IB, Chee KH, Schulman S, Singer DE, et al. Profile of patients with isolated distal deep vein thrombosis versus proximal deep vein thrombosis or pulmonary embolism: RE-COVERY DVT/PE study. Semin Thromb Hemost 2022; 48: 446-58. DOI: https://doi.org/10.1055/s-0041-1729169
Blättler W, Martinez I, Blättler IK. Diagnosis of deep venous thrombosis and alternative diseases in symptomatic outpatients. Eur J Intern Med 2004; 15: 305-11. DOI: https://doi.org/10.1016/j.ejim.2004.06.001
ten Cate-Hoek, van der Velde EF, Toll DB, van Weert HCPM, ppms LG, Büller HR, et al. Common alternative diagnoses in general practice when deep venous thrombosis is excluded. Neth J Med 2012; 70: 130-5.
Kafeza M, Shalhoub J, Salooja N, Bingham L, Spagou K, Davies AH. Systematic review of clinical prediction scores for deep vein thrombosis. Phlebology 2017; 32: 516-31. DOI: https://doi.org/10.1177/0268355516678729
Scarvelis D, Wells PS. Diagnosis and treatment of deep-vein thrombosis. CMAJ 2006; 24175: 1087-92. DOI: https://doi.org/10.1503/cmaj.060366
Lee HJ, Lee HS, Yun SJ. Comparison of 2-point and 3-point point-of-care ultrasound techniques for deep vein thrombosis at the emergency department: a meta-analysis. Medicine 2019; 98: e15791. DOI: https://doi.org/10.1097/MD.0000000000015791
Schmidt WA. Ultrasound in rheumatology. Int J Rheum Dis 2014; 17: 711-5. DOI: https://doi.org/10.1111/1756-185X.12545
Modi S, Deisler R, Gozel K, Reicks P, Irwin E, Brunsvold M, et al. Wells criteria for DVT is a reliable clinical tool to assess the risk of deep venous thrombosis in trauma patients. World J Emerg Surg 2016; 11: 24. DOI: https://doi.org/10.1186/s13017-016-0078-1
Bonde AN, Andersen A, Schultz J, Kjærgaard J, Olesen JB, Poulsen MH, et al. Lungeemboli og dyb venetrombose. 2024. Available from: https://nbv.cardio.dk/lungeemboli#tabl12_5. [Article in Danish].
Liao ST, Chiou CS, Chang CC. Pathology associated with Baker's cysts: a musculoskeletal ultrasound study. Rheumatol Int 2010; 29: 1043-7. DOI: https://doi.org/10.1007/s10067-010-1483-6
Picerno V, Filippou G, Bertoldi I, Adinolfi A, Di Sabatino V, Galeazzi M, Frediani B. Prevalence of Baker’s cyst in patients with knee pain: an ultrasonographic study. Reumatismo 2014; 65: 264-70. DOI: https://doi.org/10.4081/reumatismo.2013.715
Alhassan S, Pelinescu A, Gandhi V, Naddour M, Singh AC, Bihler E. Clinical presentation and risk factors of venous thromboembolic disease. Crit Care Nurs Q 2017; 40: 201-9. DOI: https://doi.org/10.1097/CNQ.0000000000000159
Anand SS, Wells PS, Hunt D, Brill-Edwards P, Cook D, Ginsberg JS. Does this patient have deep vein thrombosis? JAMA 1998; 279: 1094-9. DOI: https://doi.org/10.1001/jama.279.14.1094
Patel H, Sun H, Hussain AN, Vakde T. Advances in the diagnosis of venous thromboembolism: a literature review. Diagnostics 2020; 10: 365. DOI: https://doi.org/10.3390/diagnostics10060365
Wang B, Lin Y, Pan FS, Yao C, Zheng ZY, Cai D, et al. Comparison of empirical estimate of clinical pretest probability with the Wells score for diagnosis of deep vein thrombosis. Blood Coagul Fibrinolysis 2013; 24: 76-81. DOI: https://doi.org/10.1097/MBC.0b013e32835aba49
Lippi G, Franchini M, Targher G, Favaloro EJ. Help me, doctor! My D-dimer is raised. Ann Med 2009; 41: 594-605. DOI: https://doi.org/10.1080/07853890802161015
Prochaska JH, Frank B, Nagler M, Lamparter H, Weißer G, Schulz A, et al. Age-related diagnostic value of D-dimer testing and the role of inflammation in patients with suspected deep vein thrombosis. Sci Rep 2017; 7: 4591. DOI: https://doi.org/10.1038/s41598-017-04843-x

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Prevalence of musculoskeletal disorders in patients referred for suspected deep vein thrombosis: insights from a rheumatologist-led clinic. (2025). Reumatismo. https://doi.org/10.4081/reumatismo.2025.1828
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