DIAGNOSTIC METHODS FOR DEEP-VEIN THROMBOSIS

Clinical diagnosis of deep vein thrombosis (DVT) is unreliable, and tr eatment should not be undertaken without objective confirmation. The t raditional 'gold standard' for the diagnosis of DVT has been venograph y, but ultrasonic imaging has now replaced venography as the new diagn ostic standard in many hospitals. A variety of noninvasive physiologic tests are also useful in selected circumstances. These include plethy smography, Doppler flow studies, radioisotope tests, thermography and peripheral blood tests which reflect activation of coagulation or thro mbolysis. We describe the clinical application of these diagnostic pro cedures, both for symptomatic patients suspected to have DVT and for a symptomatic patients at high risk for DVT. The selection of an appropr iate diagnostic modality depends upon institutional capabilities, cost -effectiveness and individual patient circumstances.