title: Approach to the Swollen Arm With Chronic Dialysis Access: It's Not Just Deep Vein Thrombosis.
abstract: The purposes of this pictorial essay are as follows: (1) Review a systematic approach to using sonography in the initial evaluation of patients with acute arm swelling and permanent dialysis access. (2) Identify normal grayscale and Doppler findings in arteriovenous fistulas and grafts. (3) Discuss a spectrum of vascular differential diagnoses for arm swelling in this setting, including stenosis of the access, draining vein complications, thrombosis, steal syndrome, and aneurysms, as well as several nonvascular causes. (4) Recognize findings that warrant further imaging evaluation or intervention.
authors: Department of Radiology, Einstein Medical Center, Philadelphia, Pennsylvania USA.
authors: Shilpa N
authors: SN
authors: Reddy
authors: Department of Radiology, Einstein Medical Center, Philadelphia, Pennsylvania USA.
authors: Meghan C
authors: MC
authors: Boros
authors: Department of Radiology, Einstein Medical Center, Philadelphia, Pennsylvania USA. horrowm@einstein.edu mhorrow@gmail.com.
authors: Mindy M
authors: MM
authors: Horrow
mesh_terms: D000465:Algorithms; D001132:Arm; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects*; D002908:Chronic Disease; D004487:Edema / Q000000981:diagnostic imaging* / Q000209:etiology*; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D056888:Patient Positioning / Q000379:methods; D006435:Renal Dialysis / Q000009:adverse effects*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D018608:Ultrasonography, Doppler / Q000379:methods; D014680:Veins / Q000000981:diagnostic imaging; D020246:Venous Thrombosis / Q000000981:diagnostic imaging* / Q000209:etiology*
keywords: access; arm swelling; fistula; graft; hemodialysis; sonography; vascular ultrasound