Swollen, painful lower leg with tender femoral vein and calf tenderness indicates which condition?

• A. DVT
• B. Arterial occlusion
• C. Aneurysm
• D. Varicose vein

Answer: (A)

A deep vein thrombosis is the most likely explanation for a swollen, painful leg with tenderness along the femoral vein and calf. When a clot forms in the deep venous system, it blocks blood flow back toward the heart, causing increased venous pressure, edema, warmth, and tenderness in the affected leg. The localized tenderness along a deep vein—like the femoral vein—reflects inflammation of the vein itself (phlebitis) due to the thrombus. This pattern is typically unilateral and contrasts with arterial occlusion, which usually presents with the limb being painful, but pale or cool, with weak or absent pulses rather than focal deep-vein tenderness and swelling. An aneurysm would generally present as a pulsatile mass, not isolated deep-leg tenderness, and varicose veins produce visible superficial veins with aching but not the deep, focal tenderness and swelling seen in DVT. This presentation warrants urgent assessment with duplex ultrasound and appropriate anticoagulation per protocol to prevent a potential pulmonary embolism.