Point-of-Care Ultrasound in the Diagnosis of Hematoma Mimicking Deep Vein Thrombosis: A Case Report

Deep vein thrombosis (DVT) is a common yet potentially serious condition encountered by acute care physicians. However, it can present with symptoms that mimic other conditions, such as spontaneous muscle hematoma, making accurate differentiation essential. We report the case of a 38-year-old man who developed right leg swelling and tenderness seven days after an uncomplicated femoral access coronary angiogram. Clinical suspicion for DVT was supported by elevated D-dimer levels, and enoxaparin therapy was initiated. However, point-of-care ultrasound (POCUS) identified a large muscle hematoma. Orthopedic assessment ruled out compartment syndrome, and a formal Doppler ultrasound of the lower limb confirmed the diagnosis. Anticoagulation was discontinued, and a follow-up scan was scheduled to monitor hematoma resolution. This case underscores the critical role of bedside imaging in acute presentations where clinical findings may be misleading. POCUS bridged the gap between clinical suspicion and definitive diagnosis, playing a pivotal role in guiding patient management.