Hello, Whenever a patient has an elevated INR and pain in an extremity I worry about a hematoma forming causing the discomfort, especially if there has been any trauma to the area. You mentioned that you had an ultrasound, did they just look at the blood vessels do you know, or did they also look at the soft tissue where the pain was located? Sometimes a hematoma can be deeper in the muscle layer and not obvious to simple visual inspection but the ultrasound if it was directed at that specific area would have indicated the blood collection. I have had numerous patients that had hematomas like this that even the ultrasound didn t show and were picked up on on a CT scan. If you can inform me of the specific results of the ultrasound scan or find out if the scan did in fact look at the area in question that would be helpful. The physician who ordered the test would also be able to tell you which study was ordered and what they were looking for. A scan looking for blood clots doesn t always pick up hematomas. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. David Girardi, Internal Medicine Specialist