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Wells, P.S., Anderson, D.R., Rodger, M., Forgie, M., Kearon, C., Dreyer, J., et al. (2003) Evaluation of D-Dimer in the Diagnosis of Suspected Deep-Vein Thrombosis. New England Journal of Medicine, 349, 1227-1235.
https://doi.org/10.1056/nejmoa023153

has been cited by the following article:

• TITLE: Recurrent Deep Vein Thrombosis (DVT) with Negative D-Dimer in a Patient on Rivaroxaban: A Diagnostic Pitfall

  AUTHORS: Jane Chaplin, Amin Shams Akhtari, Wei Lum

  KEYWORDS: Deep Vein Thrombosis, D-dimer, Direct Oral Anticoagulant, Rivaroxaban, Ultrasound, Diagnostic Algorithm

  JOURNAL NAME: Open Journal of Emergency Medicine, Vol.13 No.4, November 7, 2025

  ABSTRACT: We present a case of a 60-year-old female with a history of recurrent venous thromboembolism (VTE), who re-presented with right leg pain and was found to have a non-occlusive deep vein thrombosis (DVT) in the common femoral vein (CFV) despite being on rivaroxaban. Notably, the D-dimer was negative, and the Wells score was one. Duplex ultrasound confirmed non-compressibility of the CFV and femoral vein (FV). This case emphasizes the limitation of D-dimer testing in patients on direct oral anticoagulants (DOACs) and the importance of considering imaging even in low pre-test probability cases when clinical suspicion persists.