Evaluation of clinical signs and symptoms in active deep venous thrombosis of the calf.

The diagnostic value of 16 signs and symptoms of active deep venous thrombosis of the calf (ADVTC) is analysed. Thirty-nine patients suspected of ADVTC were examined clinically using 16 symptoms and signs, the 125I-fibrinogen uptake test and X-ray phlebography. Active thrombosis was confirmed in 19 patients, in 20 patients the diagnosis of post-thrombotic syndrome was established. The pattern recognition procedure, carried out with the aid of 16 symptoms and signs only by a computer, was able to differentiate both conditions with 95% sensitivity and 90% specificity. The data do not comprise unexamined asymptomatic ADVTC, which type of ADVTC it is impossible to detect. The most important signs for recognition of ADVTC appeared to be (in the order of importance): painful calf pressure, a positive Meyer sign, asymmetrical oedema and a painful Lowenberg test between 80 and 139 mmHg, i.e. a painful calf and asymmetrical oedema.