We will discuss the symptoms of DVT in the following section. But how can you tell if what youre experiencing in your leg is a blood clot or simply a cramp or bruise? Venous thromboembolism (blood clots). That is why if you notice blood clot in calf symptoms, you should start treatment. Blood clots that develop in deep veins in your calf are usually caused by conditions that interfere with your blood circulation. 1-ranked heart program in the United States. ", "It was very informative, easy to read and understand.". New York, N.Y.: McGraw-Hill Education; 2015. http://accessmedicine.com. 9500 Euclid Avenue, Cleveland, Ohio 44195 |, Important Updates + Notice of Vendor Data Event, (https://orthoinfo.aaos.org/en/diseases--conditions/deep-vein-thrombosis), (https://www.heart.org/en/health-topics/venous-thromboembolism/what-is-venous-thromboembolism-vte), (https://www.cdc.gov/ncbddd/dvt/facts.html), (https://www.nhlbi.nih.gov/health-topics/venous-thromboembolism), Heart, Vascular & Thoracic Institute (Miller Family). However, the study pointed to the fact that ginger may interact with blood-thinning drugs and ginger supplements shouldnt be used by people who have low platelet count.23, Because deep vein thrombosis can have serious and potentially fatal consequences, you should seek emergency medical help if you have any of its symptoms. See a doctor if you suspect you have a blood clot, as DVT could be the start of more threatening conditions. In this invasive test, your provider numbs the skin of your neck or groin and uses a catheter to inject a special dye (contrast material) into your veins to see if any blood clots are partially or completely blocking blood flow inside your veins. Most DVTs happen in your lower leg, thigh or pelvis . NCBI. At Healthy and Natural World, our mission is to empower people to take control of their own health by providing comprehensive, practical and well researched information. If you need to take an anticoagulant, you may have to take it for only a few months (usually three to six months) or you might take it indefinitely. To provide you with the most relevant and helpful information, and understand which Youll also need to have imaging tests. (2022). Also the leg can be sensed warm if you touch it. As far as here the vein is closer to the skin, a clot forms rather easily and develops fast. Deep vein thrombosis (DVT). This causes gentle pressure (compression) on your leg. The journal Techniques in Vascular and Interventional Radiology reports that DVT often results in skin discoloration.13 As already mentioned, warmth and redness are often associated with deep vein blood clots. Follow up with your provider as directed and follow their recommendations to reduce your risk of a clot. You should always contact your doctor or other qualified healthcare professional before starting, changing, or stopping any kind of health treatment. Sometimes a clot can appear in a thigh artery and this case is accompanied with different blood clot in thigh symptoms. Because of the potentially fatal complications of a blood clot deep in a vein, you should never ignore signs of DVT. Last Updated: April 28, 2023 Policy. The provider will check the legs for swelling, tenderness or changes in skin color. JAMA. Local inflammation causes the warmness and redness of the skin of the affected area. Know that foods rich in vitamin K, like spinach, kale, and Brussels sprouts, can interfere with blood thinning medication. Pain typically occurs when walking or standing but could happen at any moment without cause, so its important to document when it happens. The blood clot in leg is rather common deviation caused by a number of factors happening both with men and women. A blood clot may form in a blood vessel, obstructing blood flow. 4 /14. Papadakis MA, et al., eds. 2012 Nov; 2(4): 499-509. We do not endorse non-Cleveland Clinic products or services. Forming inside a vein, a clot can dissolve or stay there for a continuous period. Anyone who is experiencing any of the symptoms of DVT should speak with a doctor urgently or go to the emergency room. In the early stages of DVT, a person may notice some pain, swelling, warmth, or discoloration in the affected area of the leg. Stand up and walk for a few minutes every hour while awake and especially during a long-haul flight or road trip. In some cases, there can be signs of right heart failure. Another long-term complication of deep vein thrombosis is a condition called postthrombotic syndrome. Blood clots here may be caused by fatty deposits in the walls of the blood vessels that bring blood to your brain. Deep vein thrombosis (DVT) clinical presentation. Change positions often, especially on long trips, Avoid sitting or standing for more than an hour at a time. The warning signs of blood clot in leg (pics in the gallery) go down when a person lifts his legs and keeps them in this position for a while allowing blood to flow out and relieve the pressure. Forming inside a vein, a clot can dissolve or stay there for a continuous period. Be patient. Some blood clots form inside your veins without a good reason and don't dissolve naturally. This is one of the most serious complications of DVT. You wear most compression stockings just below your knee. Mayo Clinic does not endorse companies or products. Deep vein thrombosis (DVT, also called venous thrombosis) occurs when a thrombus (blood clot) develops in veins deep in your body because your veins are injured or the blood flowing through them is too sluggish. Advertising on our site helps support our mission. National Heart, Lung, and Blood Institute. If you experience a sudden sharpness of breath, a sharp stabbing pain, or a rapid heart rate, seek medical attention immediately, since the clot may be impacting your lungs. Having an autoimmune disease, like lupus, vasculitis or. In most cases, the blood clot starts in a deep vein in the leg and travels to the lung. CDC. All rights reserved. If you learn the warning signs, youre more likely to get quick medical help that can make a huge difference in keeping you out of the danger zone. This novel blood clot treatment doesn't increase bleeding risk, Why young women have more adverse outcomes after a heart attack than young men, Gut microbiome appears to fluctuate throughout the day and across seasons, One-hour endoscopic procedure could eliminate the need for insulin for type 2 diabetes, New clues to slow aging? People who spend a lot of time sitting are at the highest risk of DVT. Dreamstime is the world`s largest stock photography community. If your doctor thinks you may have a genetic or acquired clotting disorder, you may need to have special blood tests. What are the treatment options if your doctor diagnoses a blood clot that is causing deep vein thrombosis? In time, the blood clot in your leg will dissolve and disappear. However, in some cases, you can feel the pain right up to your inner thigh.12, In fact, in some cases, symptoms of deep vein thrombosis can feel like a pulled muscle in the back of the leg (your hamstring).15. 2001 Feb; 174(2): 132136. The Agency for Healthcare Research and Quality (AHRQ) notes that the symptoms of a blood clot in a persons leg include swelling, flushed skin, pain in the leg, and the leg feeling warm to the touch. If a blood clot in the leg goes untreated, it can progress to pulmonary embolism, which is a life threatening condition. In: Harrison's Principles of Internal Medicine. Deep vein thrombosis, or DVT for short, is a serious condition that needs immediate medical attention. Dont be afraid to tell your doctor if something they do or touch hurtsyour pain can help diagnose you properly. Symptoms of postthrombotic syndrome can include:19. This greatly reduces oxygen supply to tissues in your body, and the complications of the blood clot can fatal.2. The result can be really serious. However, if you notice signs of a deep venous clot, you are at risk of developing serious complications of deep vein thrombosis. The journal Open Journal of Preventative Medicine reports that people who are overweight or obese have a greater risk of deep vein thrombosis and pulmonary embolism. Pain and swelling in the leg are common symptoms. Your body may naturally dissolve a clot, but sometimes clots dont completely disappear. Clue: Swelling. Have a family member has had a blood clot before, Have taken a long trip on a car, plane, bus, or train, Sharp or stabbing pain when breathing that worsens with deep breaths, Sudden bouts of coughing, which may contain blood or mucus. I am supposed to take thinners for life. Increased pigmentation or discoloration of your skin. Abdominal pain or flank pain (when blood clots affect the veins deep inside your abdomen). Accessed April 18, 2016. So, if you notice the first signs of blood clot in leg (picture 1), you should turn to a doctor. The blood clot in ankle (picture 2) is rather frequent and able to provoke the extreme pain in particular when a patient walks loading his legs and putting the pressure on a blood clot. 2005 - 2023 WebMD LLC, an Internet Brands company. This is called deep vein thrombosis (DVT). Children with a blood clot can also present with difficulty breathing and tachycardia, which is an elevated heart rate. Keep the clot from getting bigger and involving other veins. You can feel a kind of burn. This may be important if: A DVT may make it harder for you to get around at first because of leg pain and swelling. If we combine this information with your protected Feel if your leg is warm around the swollen or sore area. These devices help prevent a DVT if youre in the hospital, but they arent prescribed outside of the hospital. MayoClinic. Accessed April 18, 2016. These conditions can increase your risk of a deep vein thrombosis: Your healthcare provider will do a physical exam and review your medical history. Your doctor may advise you to wear stockings for 2 to 3 years if youre at higher risk for blood clots. In common they follow symptoms of a blood clot in your leg (pictures at the bottom). When a blood clot forms in one of the deep veins in your arm or leg, way beneath your skin's surface, it could be something called a deep vein thrombosis (DVT). information and will only use or disclose that information as set forth in our notice of Pictures of Blood Clot in Leg. (2021). Dr. Daniel R. Ouellette, who specializes in pulmonary care, says that large thrombi can get stuck in the main arteries of the lung. If a blood clot dislodges and travels to a persons lungs, it can cause a pulmonary embolism that can be fatal. Youll probably need to wear graded elastic compression stockings to either improve or completely get rid of leg swelling. Visually, a person may notice some discoloration, such as redness or a bluish color on the affected area of the leg. Avoid activities that may cause a serious injury. Prevent long-term complications from the blood clot (like chronic venous insufficiency). lightheadedness. References Minor leg injuries may up clot risk. Healthcare providers treat pain and swelling with nonsteroidal anti-inflammatory drugs. Medicine, medical condition, health, disease or vascular pathology concepts. Some symptoms of vein disease can be similar to those of deep vein thrombosis (DVT), a serious type of blood clot. What are blood clots and what causes them? Visually, however, it may be hard to tell the difference. The skin gets covered with blue or red tinge and it is warm if you touch it. 2008; 122(6): 763-773. The skin around painful areas or in the arm or leg with the DVT may feel warmer than other skin. 2012 Sep;41(5):360-5. Thromb Res. The area of your leg or arm thats swollen or hurts may be warmer than usual. The muscles get tired quickly that is why the leg feels like heavy. Understand your risk for excessive blood clotting. Along with painful swelling where the blood clot is located, your calf muscle may be tender to touch. 1998-2023 Mayo Foundation for Medical Education and Research (MFMER). Arterial and venous thrombosis. https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=160&contentid=39, https://medlineplus.gov/lab-tests/d-dimer-test/, https://www.ncbi.nlm.nih.gov/books/NBK425364/, https://www.venousforum.org/patients/what-is-vein-disease/what-is-deep-vein-thrombosis/, https://www.chcf.org/blog/california-dermatologists-offer-equitable-care-dark-skinned-patients/, https://www.kch.nhs.uk/Doc/pl%20-%201002.1%20-%20investigations%20for%20suspected%20blood%20clots%20during%20or%20after%20pregnancy.pdf, https://italjmed.org/index.php/ijm/article/view/itjm.2017.771/1015, https://www.stoptheclot.org/learn_more/signs-and-symptoms-of-blood-clots/, https://onlinelibrary.wiley.com/doi/full/10.1111/jth.12728, https://www.cdc.gov/ncbddd/dvt/index.html, https://www.nhlbi.nih.gov/health-topics/venous-thromboembolism, https://www.ahrq.gov/patients-consumers/prevention/disease/bloodclots.html, https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC5554122/, A safer blood thinner? Researchers concluded that walking helps to improve DVT symptoms after surgery and may prevent postthrombotic syndrome.21. Lets look at pictures of blood clots in the lower leg. Arterial embolism or embolus located in the calf with blood clot or thrombus image 3D rendering illustration. Its important to call your doctor right away or go to the emergency room if you have symptoms of a DVT. Deep vein thrombosis is a blood clot in a vein located deep within your body, usually in your leg. The CDC also recommends that people get up and walk around regularly and exercise their leg muscles while seated for extended periods. According to the AHRQ, risk factors for a blood clot include: As a variety of other conditions can present with similar symptoms, a doctor will likely recommend specialized tests to determine whether a person has a blood clot in their leg. This may be harder to see on dark skin. In: Harrison's Principles of Internal Medicine. Dr. Kuashal Patel, who is a vascular surgeon at Kaiser Permanente Los Angeles Medical Center, says that the location of the leg clot usually feels warm. This is a possible complication of untreated giant cell arteritis. New York, N.Y.: The McGraw-Hill Companies; 2016. http://accessmedicine.com. Download royalty-free stock photos, vectors, HD footage and more on Adobe Stock. It can then cause . Consult your doctor if you develop these signs or symptoms in an area on an arm or leg: Swelling; Redness; Pain; Self-care measures. What causes excessive blood clotting? This condition can be accompanied with blood clots in feet caused by long travelling hours. Another form for this deviation is blood clot in thigh (picture 4). There are 12 references cited in this article, which can be found at the bottom of the page. There is a problem with These types of blood clots rarely travel to your lungs unless they move from the superficial system into the deep venous system first. Last reviewed by a Cleveland Clinic medical professional on 03/28/2022. If there is tenderness in your leg, it can be an early sign. To detect a blood clot in your leg, watch out for swelling, which is caused by a blockage of blood flow. American Academy of Orthopaedic Surgeons. Taking your medications exactly as your healthcare provider tells you to. Treatments include medicines, compression stockings and surgery. Get out of bed and move around as soon as you can after youre sick or have surgery. This kind of blood clots in your legs (pictures below) causes a cord-like swelling. Thrombus forms in several places and can lead to a partial immobility when it is difficult for patient to move for a long time. This increases the pressure inside your veins and causes pain and swelling. You may also have discolored patches of skin, including reddish or blue patches. That can cause high blood pressure or even kidney failure. According to doctors from the Mayo Clinic, pain and swelling of one of your legs are common if you have a serious blood clot. Being older than 40 (although a DVT can affect people of any age). The Centers for Disease Control and Prevention says that traveling for longer than 4 hours on an airplane, in the car, or bus can increase the risk of leg clots in your calves.4. WebMD does not provide medical advice, diagnosis or treatment. In serious cases of DVT where there is a risk of pulmonary embolism, your doctor may blast the blood clot using a catheter. Tech Vasc Interv Radiol.2009 Jun;12(2):148-53. Research shows that your legs are the most common place for a blood clot to form.. Some people with a DVT may need to be treated in the hospital. A vascular ultrasound technologist applies pressure while scanning your arm or leg. Rather often a patient does not have signs of blood clot in calf (picture 6), but still there are a range of them. A blood clot in a leg vein may cause pain, warmth and tenderness in the affected area. Even rash, much less ulceration of the skin with discomfort in the limb should be taken into consideration. You may opt-out of email communications at any time by clicking on This may be more challenging for doctors to recognize in children with dark skin. Deep vein thrombosis is the formation of blood clots in a deep vein that can be fatal. This test uses ultrasound waves to show blood flow and blood clots in your veins. The existence of a venous clot in your lower leg or upper thigh wont in itself harm you. Sometimes, a DVT may dislodge and travel through the circulatory system toward the lungs or brain. Blood clots in your leg - a condition known as deep-vein thrombosis (DVT) - can form for a variety of reasons. been taking them because I fall almost daily from my spinal cord injury and worry about internal bleeding. Medical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. Make your tax-deductible gift and be a part of the cutting-edge research and care that's changing medicine. Sign up for wikiHow's weekly email newsletter. When we speak about blood clot in leg, we understand that it can be in any part of it including knee or rather the back of it. Making lifestyle changes, such as eating healthier foods, being more active and avoiding tobacco products. Symptoms of DVT (deep vein thrombosis) Symptoms of DVT (deep vein thrombosis) in the leg are: throbbing pain in 1 leg (rarely both legs), usually in the calf or thigh, when walking or . getting too little activity and sitting too much. There are different types of anticoagulants: warfarin, heparin and oral Xa inhibitors. A blood clot is a semisolid clump of blood that forms inside a blood vessel. "What Causes Pulmonary Embolism? The reason for swelling is that the blood clot prevents blood from flowing back up to your heart. At the same time but with different symptoms the blood clot in hand is possible, which is diagnosed properly with ultrasound. You will also learn what you can do to prevent deep leg clots and how to avoid the complications of deep vein thrombosis. Blood clots in the leg can cause swelling, irritation, and pain. Mayo Clinic College of Medicine and Science, Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic School of Graduate Medical Education, Mayo Clinic School of Continuous Professional Development, Mayo Clinic on Incontinence - Mayo Clinic Press, NEW Mayo Clinic on High Blood Pressure - Mayo Clinic Press, Mayo Clinic on Hearing and Balance - Mayo Clinic Press, FREE Mayo Clinic Diet Assessment - Mayo Clinic Press, Mayo Clinic Health Letter - FREE book - Mayo Clinic Press, Financial Assistance Documents Minnesota, Dr. Mark Truty (surgery, MN) better outcomes with chemo, What is pancreatic cancer? These may include: Another possible test is the D-dimer blood test, which checks for D-dimers protein fragments that the body produces when a clot breaks up. These symptoms are called post-thrombotic syndrome and can happen because of damage to the valves and inner lining of your veins leading to blood pooling more than it should. Magnetic Resonance Imaging (MRI) or Magnetic Resonance Venography (MRV). Get treatment right away to prevent serious complications. Dont stop or start taking any medication (including medications and supplements you take without a prescription) without asking your provider. Blood clots and aneurysms. Your guide to preventing and treating blood clots. In order to be sure it is recommended to be medically examined. information highlighted below and resubmit the form. To help you lose weight and keep the weight off, please read my article on 12 simple tweaks for weight loss. Vision loss or blindness. Post-thrombotic syndrome may also happen following a blood clot in a leg vein . Answer any questions your doctor may have about your symptoms, such as when they started or what makes them better or worse. Up to 30%of people with a DVT dont have symptoms, but sometimes the symptoms are very mild and may not raise concern. A clot that forms in your leg and doesnt dissolve on its own will cause your calf muscle to look red and tender. Watch out for symptoms like these: A blood clot in your lung usually starts out in a deep vein in your arm or leg, then breaks off and travels to your lung. Feel short of breath or have problems breathing, Severe pain in your belly, which may be worse after you eat, Pain in the side of your belly, legs, or thighs. It is a long-term condition where blood pools in the vein instead of flowing back to the heart. Other factors like obesity, pregnancy, cardiac condition, or use of birth control pills are also mentioned among the causes of blood clots in the legs. Almost any part of limb can be affected. 2016;315(10):1048-1049. According to Dr. John P. Cuhna on eMedicineHealth, the main causes of deep vein thrombosis are:3, Sitting for a long time. What does a blood clot in your leg look and feel like? Possible symptoms of a blood clot in the leg include: Pediatric thrombosis is the term for a blood clot in a child. While the latter case is characterized by intensive pain coming on abruptly, because the muscles are damaged due to oxygen deprivation. Talk to your provider about your diet. Although you cant see what the blood clot looks like, your lower leg may appear red or have a bluish tinge and look slightly swollen. close up of woman hand holding and massage her calf caused of suffering from calf pain. (2017). The blood clot in knee (pictures below) can transfer to more severe form the varicose veins behind knee looking like twisted clusters of dark-blue veins at the advanced stage. Medscape. having blood pool in your legs because valves in a superficial vein don't work properly (a varicose vein . Because of the severity, thrombolytics are only given in a hospitals intensive care unit. In most cases, the pain will start in the calf and radiate from there. But its important to know that in some cases, clots can happen with few symptoms or none at all.. How often do I need follow-up appointments? Superficial thrombophlebitis, or superficial vein thrombosis, is a blood clot that occurs in veins under the skin (superficial veins). Your provider may use a CT scan to find a DVT in your abdomen, pelvis or brain, as well as blood clots in your lung (pulmonary embolism). They are beneficial when they form in response to an injury or a cut, plugging the injured blood vessel, which stops bleeding. This is the most common test for diagnosing a DVT because it is non-invasive and widely available. DVT. As many as half of those who get a DVT in their legs develop symptoms of intermittent leg pain and swelling that may last months to years. Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press. http://www.ahrq.gov/patients-consumers/prevention/disease/bloodclots.html. A blood clot in a leg vein may cause swelling, pain, warmth and tenderness in the affected area. Include your email address to get a message when this question is answered. A pulmonary embolism is a blood clot that blocks and stops blood flow to an artery in the lung. If you have a deep vein thrombosis, youre not alone. Longo DL, et al., eds. These images can help you visualize how the symptoms of DVT manifest themselves. In fact, tenderness and pain of the calf are among the first signs of DVT that indicate you should seek medical attention.9. The area around the blood clot may feel tight or sore like you have a muscle cramp or charley horse. Usually, medication is required to prevent the symptoms and complications associated with DVT. These minimize leg pain and swelling by at least 50% if you wear them daily. When that happens, symptoms usually come on more gradually, but can still mean trouble. NHS. But even young, generally healthy people can develop blood clots. In other cases, a clot that starts out in a different part of your body, like your chest or neck, might enter your bloodstream and travel to your brain, where it can cause a stroke. This content does not have an English version. Longo DL, et al., eds. Blood clots most often start in the legs and travel up through the right side of the heart and into the lungs. The heart is a less common location for a blood clot, but it can still happen. A blood clot in your leg that is associated with deep vein thrombosis (DVT) can cause your lower leg to be sore, swollen, and red. Swelling of your leg or arm (sometimes this happens suddenly). A blood clot usually causes additional symptoms that a bruise does not, such as warm skin. wikiHow is where trusted research and expert knowledge come together. The beginning of disorder can be unnoticeable or is not clear enough to understand that it is a problem. Even though DVT itself is not life-threatening, the blood clots have the potential to break free and travel through your bloodstream. Blood clots are not something to mess around with. Understand that thrombolytics can cause excessive bleeding and are only prescribed in severe or life-threatening cases. http://www.heart.org/HEARTORG/Conditions/More/Understand-Your-Risk-for-Excessive-Blood-Clotting_UCM_448771_Article.jsp. When a clot slows or stops the flow of blood, it can build up in the vessel and make it swell. (2017). The tenderness is localized to the part of the leg where the clot is. In general symptoms of blood clot in lower leg are the same, which observed in the other areas. 15 /16. During treatment, it is obligatory to consult your doctor. The former one may cause pain higher in the thigh, which is though not a must. Youre getting treatment for another illness, like cancer or an autoimmune disease (you may need to take an anticoagulant as long as your risk of a clot is higher.). Some reports indicate that the risk of DVT could be as high as 70% if measures to prevent blood clots forming arent taken.5, Injury to your legs. If this happens, it could mean that the clot has moved from your arm . Usually blood clots happen in the deep veins in this place and lead to the more complicated condition known as deep venous thrombosis. Blood clots are gel-like clumps of blood. Several clinical studies have shown that compression stockings improve the symptoms of leg pain and swelling by at least 50% as long as theyre worn daily from morning to evening (they dont have to be worn overnight). COVID-19: Myocardial injury (adult). The medical term for a blood clot is a thrombus, and a blood clot deep in the vein of the legs is referred to as venous thrombosis. The main symptoms of pulmonary embolism include: Diagnosing a pulmonary embolism can be difficult because the symptoms are common to many other health conditions. Pulmonary embolism clinical presentation. You have a family history of a specific genetic clotting disorder. Duplex venous ultrasound. NCBI. Dr. Kuashal Patel (quoted earlier) says that usually the pain of a deep venous blood clot in the leg is localized to the calf muscle. This is dangerous, so look out for these symptoms: National Institutes of Health, National Heart, Lung, and Blood Institute: "What Causes Excessive Blood Clotting?" Is the ketogenic diet right for autoimmune conditions? How to Prevent Blood Clot in Leg. Sign up for free, and stay up to date on research advancements, health tips and current health topics, like COVID-19, plus expertise on managing health. The Western Journal of Medicine reports that a swollen lower limb caused by DVT will also cause tenderness. If it happens in your lower leg or calf, it's often a sign of DVT. This article is helpful for me. If you buy through links on our site, we may earn a commission. I haven't. Learn how to tell whether it is a blood clot or a bruise. Blood Clot Leg royalty-free images. These stockings are tight at the ankle and become looser as they go away from your ankle. J Ultrasound Med. Or sometimes, they may form because of a blow to your head that leads to a concussion. For long car trips, stop and walk around frequently. Get useful, helpful and relevant health + wellness information. This content does not have an Arabic version. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2012. A person with a blood clot in the leg or a DVT will likely receive some of the following treatments: According to the CDC, the best way to prevent a blood clot or DVT is to maintain a moderate weight, avoid a sedentary lifestyle as far as possible, and follow any lifestyle recommendations from a doctor. Doctors from the National Health Service report that swelling is often a symptom of deep vein thrombosis. CDC. It can cause pain, swelling, and red or dark, tender skin. kevin harned spouse, ford ecoblue engine reliability,
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