A comprehensive clinical examination is the basis for selecting further diagnostic steps:
- General physical examination – including blood pressure, pulse, body weight, height; further:
- Inspection (looking at) and palpation (feeling) of the calves.
- Pain provocation if deep vein thrombosis (DVT) is suspected:
- Calf compression pain (Meyer’s sign); positive: tenderness on the medial side of the lower leg along the so-called Meyer’s pressure points (inner side of the upper lower leg).
- Calf pain on dorsiflexion of the foot (Homans sign); positive: calf pain on dorsiflexion of the foot (flexion toward the dorsum of the foot) with the leg extended.
- Foot sole pressure pain (Payr’s sign); positive: pressure painfulness, especially the medial sole of the foot, when pressure is applied to the sole of the foot with the fingers
- Pain provocation if deep vein thrombosis (DVT) is suspected:
- Auscultation (listening) of the lungs
- Inspection (looking at) and palpation (feeling) of the calves.
- Orthopedic examination – especially to exclude transmission pain (Reffered Pain) from the lumbar spine, from the knee.
- Neurological examination – in case of neurological concomitant symptoms.
