Raised Skin Temperature in the Early Diagnosis of Deep-vein Thrombosis of the Legs

The reported incidence of deep-vein thrombosis in hospital patients varies from less than 1 % (Barker et al., 1940 ; Felder, 1949) to over 28% (Sevitt and Gallagher, 1959). This wide variation reflects not only differences in the populations at risk but also differences in the criteria of diagnosis and in the vigilance with which they are sought. There is general agreement that the clinical diagnosis of deep-vein thrombosis may be difficult or impossible, and the occurrence of pulmonary embolism without previous recognition of its cause is common experience. The usually accepted signs of deep-vein thrombosis are oedema, calf tenderness on pressure or on dorsiflex on of the ankle, and tenderness over the femoral vein. Some authors add cyanosis of the limb and dilated superficial veins, and a few mention raised temperature of the affected limb. Delayed cooling on exposure of the limb as an early sign of venous thrombosis was first mentioned by Pilcher (1939), who stated, "I do not remember any patient showing this sign who did not develop others " (of deep-vein thrombosis).