A Baker's dozen

A 94-year-old woman with chronic left knee osteoarthritis was referred to the deep vein thrombosis (DVT) clinic with a 2-day history of non-traumatic left calf pain and swelling, with mild restriction in knee flexion. On examination, she had focal swelling extending from mid-calf to the back of her knee, without warmth or erythaema and required support with a frame. Serum D-dimer was elevated at 439 µg/L (<250), with normal inflammatory …