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Suspected Upper-Extremity Deep Vein Thrombosis

Deep vein thrombosis (DVT) occurs when there is a clot in a vein that is deep within your body. If this happens in your upper extremity (arm, wrist, or hand), it is called upper-extremity DVT. Causes of upper-extremity DVT include trauma, infection, inflammation, heart failure, pregnancy, and cancer. Symptoms may include upper-extremity swelling, pain or tingling, heaviness, or a feeling of “pins and needles.” Upper-extremity DVTs are sometimes associated with having a device in the body such as a catheter, pacemaker, or defibrillator. These upper-extremity DVTs often have no symptoms. It is important to diagnose DVT because it may need to be treated with blood thinners. To help in the diagnosis, a doctor may ask you about symptoms, do a physical examination, or use blood tests. Imaging tests are often needed to see the location and extent of the DVT.

For suspected upper-extremity DVT, initial imaging using ultrasound duplex Doppler of the upper extremity is usually appropriate. CT of the upper extremity veins with intravenous contrast (a special dye injected into your blood) may be appropriate. MRI of the upper extremity veins (MRV) without and with contrast or MRV of the upper extremity without contrast may also be appropriate.

For more information, see the Blood Clots page.

— By Sandra V. Kotsis, MPH and Tasneem K. Lalani, MD. This information originally appeared in the Journal of the American College of Radiology.

This page was reviewed on July 15, 2022

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