|
Year |
2002 |
|---|---|
|
Question Number |
177. |
|
Category |
Orthopaedic Science |
Question
The sensitivity of color Doppler ultrasound to detect deep venous thrombosis in the lower extremity is
1- highest in the calf.
2- highest in the thigh.
3- highest in the pelvic veins.
4- comparable to venography.
5- operator independent.
Figures
Answer (click for answer)
Answer – 2
Color Doppler ultrasound has been very effective in the detection of symptomatic DVT. Application of this modality as a screening tool for the identification of non-occlusive asymptomatic thrombosis in the post-op setting provides a greater challenge. Thrombi in the thigh have been successfully identified in several centers, but identification of calf thrombi is highly variable. Various studies have compared color Doppler to venography with sensitivities of Doppler ranging from 12% to 62% for the detection of thrombi. Pelvic veins are difficult to evaluate with Doppler due to their non-compressibility and intervening bowel gas. Doppler evaluation is also highly operator dependent.
Reference: Salvati EA, Pellegrini VD, Sharrock NE, et al: Recent advances in venous thromboembolic prophylaxis during and after total hip replacement. JBJS 2000; 82: 252-270.