Stephen Bird

Hi Sandy,

You make a very good observation here and I think it is mandatory that whenever you see a lower limb muscle injury like a medial gastrocnemius tear, solar tear or Achilles injury that we perform a basic DVT examination of the adjacent veins and also the popliteal vein to check for DVT.

It all comes back to old fashioned medicine and Virchows Triad.

Virchows Triad is the risk factors for developing a clot.

The triad consists of:

Hypercoagulatable state

In the case of a medial gastrocnemius tear for example you have just created 2 of these conditions.

There is the trauma of the injury and also the stasis caused by the injury which means you will not be moving freely and may immobilise the limb.

Hence you have created a great situation to form a DVT.

In terms of the patients global health you could well argue diagnosing the MSK tear is important, however diagnosing the DVT is even more important.

The muscle tear is painful and an inconvenience, however a DVT and pulmonary embolus may be lethal.


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