Identification of a Deep Vein Thrombosis in a Dark-Skinned Male: Finding Limitations in the Wells Criteria

BACKGROUND: The prevalence of postoperative complications following Achilles tendon repair is approximately 11.6%, with deep vein thrombosis (DVT) representing a significant risk. CASE PRESENTATION: This case study presents a 31-year-old African American male who developed multiple DVTs 4 weeks postsurgery. Despite a low score on the Wells Criteria, which assesses DVT risk, the patient’s clinical presentation, severe calf pain, and localized tenderness warranted further investigation. OUTCOME AND FOLLOW-UP: Following urgent vascular testing, the patient was diagnosed with DVT and initiated anticoagulant therapy. DISCUSSION: The case underscores limitations of the Wells Criteria when applied to dark-skinned individuals, highlighting the necessity for extra vigilance and thorough clinical assessments in postoperative patients, especially those at higher risk for complications. Future research should explore the diagnostic accuracy of DVT screening tools across diverse populations to improve clinical outcomes for dark-skinned patients. JOSPT Cases 2025;5(3):171-175. Epub 19 June 2025. doi:10.2519/josptcases.2025.0142