Cancer currently treated, OR treatment within the past 6 months, OR palliative only.
Paralysis, paresis, or recent LE plaster immobilization Lower-limb paralysis/paresis OR plaster cast on the leg within the past 12 weeks.
Bedridden ≥ 3 days OR major surgery within 12 weeks Recent bedrest ≥ 3 days OR major surgery within the past 12 weeks under general or regional anaesthesia.
Localized tenderness along the deep venous system Tenderness on palpation along the popliteal / femoral vein course in the symptomatic leg.
Diffuse swelling involving the whole limb, not just the calf.
Calf swelling ≥ 3 cm vs asymptomatic side Measured 10 cm below the tibial tuberosity; ≥ 3 cm difference between legs.
Pitting edema confined to symptomatic leg Pitting edema in the symptomatic leg only — not bilateral.
Collateral superficial (non-varicose) veins New non-varicose superficial veins suggesting collateral flow around an occluded deep vein.
Previously documented DVT Prior objectively-confirmed deep vein thrombosis (any site, any side).
Alternative diagnosis at least as likely as DVT Subtracts 2 points if true — flips low-risk gestalt (cellulitis, Baker cyst, post-thrombotic syndrome, etc.).