In the Wells scoring system for suspected lower limb deep vein thrombosis, which single feature carries a negative score?
- A Calf swelling more than 3 cm greater than the other leg
- B An alternative diagnosis at least as likely as deep vein thrombosis ✓
- C Recently documented previous deep vein thrombosis
- D Pitting oedema confined to the symptomatic leg
Correct answer: B. An alternative diagnosis at least as likely as deep vein thrombosis
Explanation
The Wells score assigns minus 2 points when another diagnosis is considered at least as likely as DVT, reflecting that competing explanations such as cellulitis or muscle tear lower pretest probability. All other listed features are positive criteria worth 1 point each. A total score of 2 or more places the patient in the 'likely' category, mandating proximal leg vein ultrasonography rather than D-dimer alone.
Reference: Bailey and Love's Short Practice of Surgery, 28th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.