MAKE IT EASY - DUPLEX EXAMINATION OF THE VENOUS SYSTEM

Objective: A methodological report of duplex ultrasound examination of the venous system, with particular consideration of the best position for examining the patient. Design: Single patient group, comparison of duplex ultrasound imaging with phlebography. Setting: Teaching hospital vascular laboratory. Patients: Patients referred for assessment of their venous system. Main outcome measures: Duplex ultrasound scanning of the lower limb, ascending phlebography. Results: Our results of duplex ultrasound scanning in the diagnosis of deep vein thrombosis as compared with phlebography show a sensitivity of 94% and a specificity of 91%. Conclusions: We found it advantageous to examine the patient standing during proximal vein imaging and sitting for distal venous examination. Veins dilated as a result of gravitational effects are visualized more easily. The examiner, by resting the elbow on his/her distal thigh, has a more stable hand, facilitating the test. The patient, by resting the heel on the edge of the examiner's chair, relaxes the calf muscles, thus simplifying the augmentation manoeuvre. The inflation of a tourniquet applied to the distal thigh dilates the calf veins.