Difference between revisions of "Ultrasonography of deep vein thrombosis of the lower extremity"

From radlines.org
Jump to navigation Jump to search
m (→‎Planning: Thumb)
(→‎Evaluation: +Lower leg)
Line 8: Line 8:
 
==Evaluation==
 
==Evaluation==
 
[[File:Ultrasonography of deep vein thrombosis of the femoral vein -annotated.jpg|thumb|[[Doppler ultrasonography]] showing absence of flow and hyperechogenic content in thrombosed femoral vein.]]
 
[[File:Ultrasonography of deep vein thrombosis of the femoral vein -annotated.jpg|thumb|[[Doppler ultrasonography]] showing absence of flow and hyperechogenic content in thrombosed femoral vein.]]
Follow the femoral vein and popliteal vein. Look for:
+
Start as high as possible in the inguinal region where you can clearly see the external iliac vein, and then follow the femoral vein and popliteal vein with the probe. Compress the vein at regular distances, such as totaling at least 7 locations. Look for:
 
*Hyperechoic content.
 
*Hyperechoic content.
*Absence of compressibility
+
*Absence of compressibility. However, adequate compression is usually not possible by the area where the vein passes through the adductor hiatus.
 
A decrease in Doppler flow raises the suspicion, but has less sensitivity and specificity.
 
A decrease in Doppler flow raises the suspicion, but has less sensitivity and specificity.
 +
 +
===Lower leg===
 +
If a lower ultrasound of the lower leg is indicated in the algorithm above, also evaluate the posterior tibial veins (at least distally near the ankle), the fibular veins (either beneath the posterior tibial vein, better seen when going about half way up the lower leg) as well as the anterior tibial vein (at least proximally).
 +
<gallery widths=250 heights=180>
 +
File:Ultrasonography of thrombosis of the fibular veins, coronal plane, annotated.jpg|Coronal plane, seen from medial side of lower leg, showing thrombosis of the fibular veins, with hyperechoic content and only marginal blood flow.
 +
</gallery>
 
{{Bottom}}
 
{{Bottom}}

Revision as of 12:25, 29 May 2019

Author: Mikael Häggström [notes 1]

Planning

Swedish algorithm.[1]

Evaluation

Doppler ultrasonography showing absence of flow and hyperechogenic content in thrombosed femoral vein.

Start as high as possible in the inguinal region where you can clearly see the external iliac vein, and then follow the femoral vein and popliteal vein with the probe. Compress the vein at regular distances, such as totaling at least 7 locations. Look for:

  • Hyperechoic content.
  • Absence of compressibility. However, adequate compression is usually not possible by the area where the vein passes through the adductor hiatus.

A decrease in Doppler flow raises the suspicion, but has less sensitivity and specificity.

Lower leg

If a lower ultrasound of the lower leg is indicated in the algorithm above, also evaluate the posterior tibial veins (at least distally near the ankle), the fibular veins (either beneath the posterior tibial vein, better seen when going about half way up the lower leg) as well as the anterior tibial vein (at least proximally).

Notes

  1. For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Radlines:Authorship for details.

References

  1. Docent Henry Eriksson, Med dr, överläkare Fariba Baghaei, Specialistläkare Valerie Bockisch, Professor emerita Margareta Hellgren, Docent Leif Lapidus, Överläkare Per-Åke Moström, Med dr, Överläkare Vladimir Radulovic, Överläkare Lennart Stigendal. Djup ventrombos, DVT. Internetmedicin. Updated 2017-06-11