title: Non-thrombotic abnormalities on lower extremity venous duplex ultrasound examinations.
abstract: BACKGROUND
  Emergency physician-performed compression ultrasonography focuses primarily on the evaluation of the proximal veins of the lower extremity in patients with suspected deep venous thrombosis (DVT). A detailed sonographic evaluation of lower extremity is not performed. The objective of this study was to determine the prevalence of non-thrombotic findings on comprehensive lower extremity venous duplex ultrasound (US) examinations performed on emergency department (ED) patients.
  
  
  METHODS
  We performed a retrospective six-year review of an academic ED's records of adult patients who underwent a comprehensive lower extremity duplex venous US examination for the evaluation of DVT. The entire US report was thoroughly reviewed for non-thrombotic findings.
  
  
  RESULTS
  We detected non-thrombotic findings in 263 (11%, 95% CI [9.5-11.9%]) patients. Among the non-thrombotic findings, venous valvular incompetence (81, 30%) was the most frequent, followed by cyst/mass (41, 15%), lymphadenopathy (33, 12%), phlebitis (12, 4.5%), hematoma (8, 3%), cellulitis (1, 0.3%) and other (6, 2.2%).
  
  
  CONCLUSIONS
  In our study, we detected a variety of non-thrombotic abnormalities on comprehensive lower extremity venous duplex US examinations performed on ED patients. Some of these abnormalities could be clinically significant and potentially be detected with point-of-care lower extremity US examinations if the symptomatic region is evaluated. In addition to assessment of the proximal veins for DVT, we recommend sonographic evaluation of the symptomatic area in the lower extremity when performing point-of-care ultrasound examinations to identify non-thrombotic abnormalities that may require immediate intervention or close follow up.
authors.affiliation: University of Arizona Medical Center, Department of Emergency Medicine, Tucson, Arizona.
authors.forename: Srikar
authors.initials: S
authors.lastname: Adhikari
authors.affiliation: University of Nebraska Medical Center, Department of Emergency Medicine, Omaha, Nebraska.
authors.forename: Wes
authors.initials: W
authors.lastname: Zeger
mesh_terms: D000328:Adult; D004636:Emergency Service, Hospital; D006801:Humans; D035002:Lower Extremity / Q000098:blood supply* / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D018616:Ultrasonography, Doppler, Duplex; D014652:Vascular Diseases / Q000000981:diagnostic imaging*; D020246:Venous Thrombosis / Q000000981:diagnostic imaging*
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