DOES THE ASYMPTOMATIC LIMB HARBOR DEEP VENOUS THROMBOSIS

Deep venous thrombosis (DVT) is a great masquerader that cannot be rel iably predicted by a patient's symptoms, history, or risk factors. Bil ateral lower extremity duplex ultrasonography scans were made of 2,511 patients and analyzed to identify, if possible, a population in which a unilateral study would be appropriate. A total of 1,086 (43%) patie nts were found to have deep venous thrombosis-742 (30%) unilateral and 344 (14%) bilateral. Of the patients with DVT for whom side-of-sympto ms referable to the involved extremity and 36% had symptoms referable to the contralateral extremity. Of the 362 patients who had asymptomat ic lower extremities, 128 (35%) had DVT. Moreover, clots were found in asymptomatic limbs in an additional 263 patients whose contralateral limb was symptomatic. Logistic regression analysis did not reveal comb inations of symptoms and risk factors that could predict DVT. If DVT i s suspected, the patient should undergo bilateral lower extremity dupl ex scanning.