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What Causes Immediate Blood Clot On Leg After An Injury When Suffring From DVT?

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Posted on Mon, 30 Jun 2014
Question: I am a 65 yr. old female with a history of DVT caused by the Factor 5 mutation. Last night I took a pretty bad fall and a few heavy items fell on top of the leg I've previously had the Clots in, and it has been hurting pretty badly, enough so that I cannot walk without a cane and when I try to bend my foot upwards I nearly fall with the pain. Could a bood clot occur in seconds or might I have only bruised that section to the point that the symptoms are the same as with DVT?
doctor
Answered by Dr. Hardik Thakker (1 hour later)
Brief Answer:
Please read the response

Detailed Answer:
Dear XXXX

Greetings from health care magic!!! I am Dr Thakker and shall be answering your question.

I have read your clinical history, past medical history and the current medication.
I feel you could have sustained a ligament injury or a fracture which is causing you great pain and difficulty in walking. Clots do not form within seconds of a fall. This is more of a traumatic injury to your leg. Clots occur when foot is immobilised for long hours. This is not the case with you.

I would recommend you to have an urgent x-ray of you leg taken to rule out a fracture. pain killer, calcium will help you symptomatically.

I hope this helps you out. If you have any more questions, please do not hesitate to write back to me.

Yours sincerely,
Dr Thakker.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
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Follow up: Dr. Hardik Thakker (4 hours later)
Thank-you, That is what I thought, that it counldn't be a blood clot instantaniously at the time of the fall. It is just very strange to me that it feels exactly the same way in every way, except that in this instance my whole upper calf area feels hard, yet very tender (sore, hurts to touch) and has been very warm. I am not just totally sitting or laying down, but walking, and continually moving my foot. It hurts the most when I stand up and try to straighten my leg, or completely straightening my leg when I walk. I KNOW that it isn't a fracture of any kind, it is a soft tissue injury. Do you think what I stated I am doing initially for treatment should be sufficient? Heat appied seems to do the best to lossen it up when I get up to walk, only sitting or even lying down ,it hurts much more when I do get up to walk, Is that something synonymous with a soft tissue injury like the muscle or ligaments and can it be okay if not over doing it, taking care of it myslf? I am definitely not going to just sit, I KNOW that isn't good for my leg, but I'll also not overdo like working in the yard, heavy lifting and carrying things and all that kind of thing to put more strain on my leg muscles and ligaments. So do you think it can be okay on it's own this way? Do you have any other medical suggestions for me other than these? And do you think it is okay to be up walking, trying to walk normally, even with the pain it causes?
doctor
Answered by Dr. Hardik Thakker (3 hours later)
Brief Answer:
Please read detailed reply

Detailed Answer:
Dear XXXX

I have the following recommendations for you:

Please have an x ray of the leg to rule out a fracture. At your age of 65yrs, the bones are osteoporotic. They are prone to fractures even with trivial injury.

You can have calcium and vitamin D3 supplementation.

Since you are on warfarin, you may have developed a hematoma in the leg and the knee area. We need to do an ultrasound and MRI later to rule this out.

Hot water fomentation, short wave diathermy are helpful in relieving pain.


I hope this helps you out. If you have any more questions, please do not hesitate to write back to me.

Yours sincerely,
Dr Thakker.

Above answer was peer-reviewed by : Dr. Yogesh D
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Follow up: Dr. Hardik Thakker (2 hours later)
Dr. Thakker, I have never heard of taking calcium and vitamin D3 supplementation for an injury, this is new to me. Nor have I ever heard of the Hot water formentation, or short wave diathermy to relieve the pain. I'd like to know a little more about it if you wouldn't mind. All other things aside though, I do think now that I just might have a hematoma there. It has become hard, red and hot even though I am walking better already and that is something I never even had before when I had the DVT and spent a week and more in the hospital each time. The ultrasounds showed them up clearly and yet there was NO swelling, redness or heat in the area. My doctor didn't believe me when I went in for my checkup and told him that I had blood clots again because it looked and felt so normal. This is why I am a little more stupified by this the way it is now. So, tell me please, is there a difference between a blood clot and a hematoma? And if so, how long is a normal recovery time? Basicly or on average? Thank-You very much for your answers and patience. Sincerely, XXXX
P.S. I await your final answers to these few more questions.
doctor
Answered by Dr. Hardik Thakker (12 hours later)
Brief Answer:
please refer to the response

Detailed Answer:
Dear XXXX

Let me be very clear of what I want to say. Vitamin D3 and calcium is not for injury. It sounds too foolish if you quote me in that reference. I have advised that for a better healing of a suspected fracture. Your bones are extremely brittle at 65 with post menopausal osteoporosis.

Hot water fomentation and short wave diathermy are used as treatment modalities for pain by most orthopedic doctor. You may not be aware of these technique if you are not a doctor. But I am sure your orthopedician will know about it.

You should not sit back and think to assume your diagnosis. This is an era of evidence based medicine. You need an urgent x ray and most probably an ultrasound and MRI.

Blood clot refers to clotting in the deep veins of the leg. This presents with swelling of leg, pain. Hematoma refers to the blood accumulation in the soft tissue and this presents with swelling, bruise, and skin discoloration. In your case this could be from warfarin and superimposed trauma.

Blood clot in the veins needs 4 to 6 weeks to resolve alone with heparin and warfarin.

Hematoma take anything from 2weeks to 6 weeks depending on the size and the depth. Here you need to stop warfarin.

I hope this helps you out. If you have any more questions, please do not hesitate to write back to me.

Yours sincerely,
Dr Thakker.
Note: For further follow-up it is advisable to consult an emergency medicine specialist. Click here.

Above answer was peer-reviewed by : Dr. Prasad
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Answered by
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Dr. Hardik Thakker

Internal Medicine Specialist

Practicing since :2006

Answered : 161 Questions

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What Causes Immediate Blood Clot On Leg After An Injury When Suffring From DVT?

Brief Answer: Please read the response Detailed Answer: Dear XXXX Greetings from health care magic!!! I am Dr Thakker and shall be answering your question. I have read your clinical history, past medical history and the current medication. I feel you could have sustained a ligament injury or a fracture which is causing you great pain and difficulty in walking. Clots do not form within seconds of a fall. This is more of a traumatic injury to your leg. Clots occur when foot is immobilised for long hours. This is not the case with you. I would recommend you to have an urgent x-ray of you leg taken to rule out a fracture. pain killer, calcium will help you symptomatically. I hope this helps you out. If you have any more questions, please do not hesitate to write back to me. Yours sincerely, Dr Thakker.