Compression ultrasonography for diagnosing deep vein thrombosis

TL;DRAbstract

Editor—We advise caution in adopting the proposed abbreviated examination protocol for detecting deep vein thrombosis in the leg.1,2 Our experience using duplex ultrasonography to study the natural course of deep vein thrombosis leads us to make the following points. Firstly, it is incorrect that calf deep vein thrombosis cannot be accurately diagnosed by duplex ultrasonography. Many reports from expert centres refute such an opinion, although we agree that the skill and experience of the sonographer is important. Secondly, about 14% of isolated calf deep vein thromboses propagate into the proximal veins. Others have reported an incidence of up to 20% propagation.3 Thirdly, because of the varying attitudes to management of isolated calf deep vein thrombosis some will argue against the need to investigate these veins on the basis that pharmacological treatment is not contemplated. Fourthly, isolated superficial femoral deep vein thrombosis without involvement of the popli

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