December Case #1

50 y/o WM presents to the ED with complaints of R leg pain for 3 days. He denies trauma or physical exertion. He admits to edema localized to the thigh, but denies calf swelling. Denies redness, warmth or pointing of the skin.
PMHx: HTN
PSHx: none
Social: denies ETOH, tobacco or drug use
Meds: HCTZ
Allergies: NKDA

PE: VS WNL
GEN: WNWD, WM, NAD
CHEST: CTA B
CV: RRR, no M/R/G
ABD: soft, NTND, +BS
EXT: no C/C, edema to R mid thigh with tenderness to palpation that extends to R calf, distal pulses 2+ bilaterally. No palpable cords noted

Bedside ultrasound is performed to rule out deep venous thrombosis:


What is your interpretation of this DVT study?

While scanning for DVT the patient states, "the pain is actually here" and points to the medial thigh. The area is then scanned and the following are noted:




What is the diagnosis?