DEEP VENOUS THROMBOSIS IN ORTHOPEDIC PATIENTS - IMPROVING THE SPECIFICITY OF DIAGNOSIS

The diagnosis of deep vein thrombosis after total joint arthroplasty i s difficult. The most widely used method of detection is physical exam ination and selective venography, which are unreliable and expensive e ven when symptoms and signs are prominent. This study employed compute rized strain gauge plethysmography (CSGP) to select symptomatic patien ts for venography. The incidence of detection by CSGP was increased fr om 16% to 81.7%. Repeated CSGP also was investigated, but although spe cificity was further enhanced, it was at the expense of sensitivity. T he negative predictive value of the CSGP screening was high and compar able to that of venography and indicates that CSGP is useful in the ma nagement of patients with symptoms suggestive of deep vein thrombosis. Computerized strain gauge plethysmography results emphasize the low s pecificity and poor feasibility of clinical examination and venography . Computerized strain gauge plethysmography is strongly advocated as a selection procedure for invasive venography in total joint arthroplas ty patients.