Bilateral lower extremity US in the patient with bilateral symptoms of deep venous thrombosis: assessment of need

Abstract

Purpose: To assess the frequency of lower extremity deep venous thrombosis (DVT) detected with ultrasound (US) in patients with bilateral symptoms suggestive of DVT.

Materials and methods: Fifty patients with bilateral lower extremity symptoms suggestive of DVT were examined prospectively for predisposing factors and type of symptoms. Charts were reviewed for previous lower extremity disease or chronic illness that could explain the patient's symptoms. The frequency of DVT diagnosed with US in this patient group was determined.

Results: No DVT was identified in the patients with bilateral symptoms suggestive of DVT. Retrospective review demonstrated that 34 (68%) of the patients had a preexisting condition (cardiac disease, venous insufficiency, chronic swelling, cellulitis or thrombophlebitis, peripheral arterial disease). Because compression US has a greater than 90% sensitivity and specificity for the diagnosis of DVT, these results were statistically significant (P < .001).

Conclusion: The likelihood of DVT in patients with bilateral lower extremity symptoms is extremely low. Alternative causes should be carefully explored before lower extremity US is considered.