A patient visits a chiropractor with localized, deep calf pain not due to injury and a history of long smoking, oral contraceptives, and long airplane travel. Which orthopedic examination would be best performed?

A patient visits a chiropractor with localized, deep calf pain not due to injury and a history of long smoking, oral contraceptives, and long airplane travel. Which orthopedic examination would be best performed?

• A. Drawer Test
• B. Morton Test
• C. Homans Sign
• D. Hoover Test

Answer: (C)

Focus on recognizing potential deep venous thrombosis (DVT) from the presentation and risk factors. Localized deep calf pain in a patient with long airplane travel, smoking, and estrogen-containing oral contraceptives raises strong suspicion for DVT, which can be a medical emergency due to the risk of pulmonary embolism. The screening exam commonly taught for DVT in this setting is a provocative test that involves dorsiflexing the ankle to stress the calf and detect pain or discomfort associated with a clot in the deep veins. A positive finding would prompt urgent imaging (like duplex ultrasound) and further evaluation. The other tests target different problems: a knee ligament test, a forefoot nerve-related test, and a test used to assess effort or malingering. Those do not address the suspected DVT in this scenario, making the DVT-focused examination the best choice here.

Focus on recognizing potential deep venous thrombosis (DVT) from the presentation and risk factors. Localized deep calf pain in a patient with long airplane travel, smoking, and estrogen-containing oral contraceptives raises strong suspicion for DVT, which can be a medical emergency due to the risk of pulmonary embolism. The screening exam commonly taught for DVT in this setting is a provocative test that involves dorsiflexing the ankle to stress the calf and detect pain or discomfort associated with a clot in the deep veins. A positive finding would prompt urgent imaging (like duplex ultrasound) and further evaluation.

The other tests target different problems: a knee ligament test, a forefoot nerve-related test, and a test used to assess effort or malingering. Those do not address the suspected DVT in this scenario, making the DVT-focused examination the best choice here.