title: Types, frequency, and significance of alternative diagnoses found during duplex Doppler venous examinations of the lower extremities.
abstract: This paper reports the alternative diagnoses identified during duplex Doppler venous examinations (DDVE) of the lower extremities and their significance in patient management to emphasize the importance of careful imaging of the site of maximum symptoms as well as of the venous system, particularly when a DDVE is negative for thrombus. Because numerous other papers have already verified the sensitivity, specificity, and criteria for the diagnosis of thrombophlebitis by ultrasonography, this study evaluates only the alternative diagnoses. In a 1-year period, 886 examinations were performed on 664 patients. Of these, 657 examinations (67%) in 457 patients were negative for deep vein thrombosis (DVT). Fifty-one of these examinations in 51 different patients resulted in an alternative positive diagnosis believed to account for the patient's symptoms. These 51 patients make up 11.25% of the patients negative for DVT (51/457), 5.7% of all examinations (51/886), and 7.7% of all patients studied (51/664). Alternative diagnoses, which occur frequently and are significant, should be considered when performing a DDVE, because ultrasonography is the only commonly used imaging modality by which these alternative diagnoses can be made.
authors.affiliation: Department of Radiology, Penrose Hospital, Colorado Springs, Colorado 80933.
authors.forename: J P
authors.initials: JP
authors.lastname: Borgstede
authors.forename: G E
authors.initials: GE
authors.lastname: Clagett
mesh_terms: D003937:Diagnosis, Differential; D006801:Humans; D007866:Leg / Q000098:blood supply* / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D014463:Ultrasonography; D014652:Vascular Diseases / Q000000981:diagnostic imaging*