Deep Vein Thrombosis in a Young, Physically Active Man

A 39-year-old man injured his left leg while downhill skiing. A physician at the ski resort diagnosed a partial soleus tear and advised rest; however, the patient resumed skiing with minimal pain 2 days after the injury. Five days post injury, he returned home via a 13-hour car ride. The following day, he self-referred to physical therapy due to swelling in the left lower leg. Based on the presentation and considering the 13-hour car ride, the patient was referred to the emergency department to rule out deep vein thrombosis (DVT). At the emergency department, a positive D-dimer blood test indicated a DVT, and partial thrombosis in the posterior tibial vein was confirmed by diagnostic ultrasound.