DUPLEX ULTRASOUND EXAMINATION OF THE ACUTELY PAINFUL AND SWOLLEN LEG

OBJECTIVE. The aim of this study was to assess the value of duplex ult rasound examination in establishing diagnosis in acutely swollen and p ainful lower limbs, and to examine how often the diagnosis of superfic ial and/or deep venous thrombosis can be made in the symptomatic legs. METHODS. Venous duplex scan examination was performed on 188 extremit ies of 180 ambulatory outpatients. The examination included testing pa tency and competency of the deep and superficial veins. The ultrasound study was also extended to finding soft tissue abnormalities. RESULTS . Of the 188 lower limbs venous thrombosis was found on 82 occasions: 29 legs contained deep venous thrombosis only; 23 legs presented with superficial thrombophlebitis as a sole venous pathology; and in 30 cas es superficial and deep venous thrombosis coexisted. In those 106 limb s where venous thrombosis was not present the most frequent positive u ltrasound findings were incompetent leg veins or soft tissue masses (B aker's cyst and calf haematoma). CONCLUSION. The variety of pathologic al processes related to the lower limb veins and the extravascular tis sue suggest that routine, ''detailed'' ultrasound scanning would be in dicated in all acutely symptomatic legs with a suspected venous disord er. The important diagnostic information so gained provides guidance t o the most appropriate treatment strategy.