BMJ 1998;316:1532 ( 16 May )

Letters

Compression ultrasonography for diagnosing deep vein thrombosis

    One examination of whole leg is better than two of selected parts
    Other tests should not be abandoned
    Venography is more accurate
    Colour Doppler provides useful information
    Protocol is safe
    Repeat testing is unjustified
    Authors' reply

One examination of whole leg is better than two of selected parts

The first 150 words of the full text of this article appear below.

EDITOR---We advise caution in adopting the proposed abbreviated examination protocol for detecting deep vein thrombosis in the leg. 1 2 Our experience using duplex ultrasonography to study the natural course of deep vein thrombosis leads us to make the following points.

Firstly, it is incorrect that calf deep vein thrombosis cannot be accurately diagnosed by duplex ultrasonography. Many reports from expert centres refute such an opinion, although we agree that the skill and experience of the sonographer is important.

Secondly, about 14% of isolated calf deep vein thromboses propagate into the proximal veins. Others have reported an incidence of up to 20% propagation.3

Thirdly, because of the varying attitudes to management of isolated calf deep vein thrombosis some will argue against the need to investigate these veins on the basis that pharmacological treatment is not contemplated.

Fourthly, isolated superficial femoral deep vein thrombosis without involvement of the popliteal (distal) or . . . [Full text of this article]
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Relevant Article

Compression ultrasonography for diagnostic management of patients with clinically suspected deep vein thrombosis: prospective cohort study
Alberto Cogo, Anthonie W A Lensing, Maria M W Koopman, Franco Piovella, Sergio Siragusa, Philip S Wells, Sabina Villalta, Harry R Büller, Alexander G G Turpie, and Paolo Prandoni
BMJ 1998 316: 17-20. [Abstract] [Full Text] [PDF]

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