A Sinister Development -- A 35-year-old woman presented to the emergency department with a 2-day history of progressive swelling and pain in her left leg, without antecedent trauma

doi:10.1056/NEJMcps061337

Volume 357:53-59		July 5, 2007		Number 1

A Sinister Development — A 35-year-old woman presented to the emergency department with a 2-day history of progressive swelling and pain in her left leg, without antecedent trauma

Reza Fazel, M.D., James B. Froehlich, M.D., M.P.H., David M. Williams, M.D., Sanjay Saint, M.D., M.P.H., and Brahmajee K. Nallamothu, M.D., M.P.H.

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In this Journal feature, information about a real patient ispresented in stages (boldface type) to an expert clinician,who responds to the information, sharing his or her reasoningwith the reader (regular type). The authors' commentary follows.

A 35-year-old woman presented to the emergency department witha 2-day history of progressive swelling and pain in her leftleg, without antecedent trauma. Her pain worsened acutely duringthe morning before her arrival. She felt warm but reported nofever or chills. She also reported mild dyspnea during the previousday, with no associated chest discomfort. She reported no recenttrauma . . . [Full Text of this Article]

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Source Information

From the Division of Cardiology, Emory University, Atlanta (R.F.); the Departments of Internal Medicine (J.B.F., S.S., B.K.N.) and Radiology (D.M.W.), University of Michigan, Ann Arbor; and the Health Services Research and Development Center of Excellence, Ann Arbor Veterans Affairs Medical Center, Ann Arbor, MI (S.S., B.K.N.).

Address reprint requests to Dr. Fazel at the Division of Cardiology, Emory University, 1639 Pierce Dr., Suite 319, Atlanta, GA 30322, or at rfazel@emory.edu.