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Diagnosis of deep vein thrombosis.
Am J Health Syst Pharm. 1997 Jan 01; 54(1):66-74.AJ

Abstract

The diagnosis of deep vein thrombosis (DVT) is discussed. Accurately diagnosing DVT is critical to making appropriate treatment decisions. Careful patient assessment, combined with objective testing, improves the accuracy of the diagnosis and reduces the likelihood of inappropriate treatment. Venography remains the reference standard for the diagnosis of DVT but is expensive, invasive, and prone to inducing complications. Ultrasonography has become the most frequently used noninvasive test for symptomatic DVT because it is highly sensitive and specific in the hands of an experienced examiner. Impedance plethysmography also has been widely used, but recent studies suggest that it is less sensitive than once believed. The radiolabeled 125I-fibrinogen uptake test is no longer available because of concerns about the transmission of blood-borne pathogens. Current thermographic techniques have relatively high sensitivity but poor specificity for DVT. Magnetic resonance imaging and computed tomography are useful adjunctive tests, but their use is limited by cost and availability. D-dimer whole-blood testing may prove to be a rapid and convenient means of ruling out the diagnosis of DVT at the bedside, but further study is needed. When used alone, none of the noninvasive methods is sufficiently sensitive for the evaluation of asymptomatic patients. The diagnostic strategy used should be based on whether the patient is symptomatic or asymptomatic, whether the event is a first one or is recurrent, and a careful clinical assessment. Accurate diagnosis of deep vein thrombosis relies on both testing and patients assessment.

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Authors+Show Affiliations

Haines ST
Department of Pharmacy Practice and Science, School of Pharmacy, University of Maryland at Baltimore 21201-1715, USA. shaines@umabnet.ab.umd.edu
Bussey HI
No affiliation info available

MeSH

Diagnostic ImagingFibrin Fibrinogen Degradation ProductsHumansRisk FactorsThrombophlebitisUltrasonography

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

9117794

Citation

Haines, S T., and H I. Bussey. "Diagnosis of Deep Vein Thrombosis." American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists, vol. 54, no. 1, 1997, pp. 66-74.
Haines ST, Bussey HI. Diagnosis of deep vein thrombosis. Am J Health Syst Pharm. 1997;54(1):66-74.
Haines, S. T., & Bussey, H. I. (1997). Diagnosis of deep vein thrombosis. American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists, 54(1), 66-74.
Haines ST, Bussey HI. Diagnosis of Deep Vein Thrombosis. Am J Health Syst Pharm. 1997 Jan 1;54(1):66-74. PubMed PMID: 9117794.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Diagnosis of deep vein thrombosis. AU - Haines,S T, AU - Bussey,H I, PY - 1997/1/1/pubmed PY - 1997/1/1/medline PY - 1997/1/1/entrez SP - 66 EP - 74 JF - American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists JO - Am J Health Syst Pharm VL - 54 IS - 1 N2 - The diagnosis of deep vein thrombosis (DVT) is discussed. Accurately diagnosing DVT is critical to making appropriate treatment decisions. Careful patient assessment, combined with objective testing, improves the accuracy of the diagnosis and reduces the likelihood of inappropriate treatment. Venography remains the reference standard for the diagnosis of DVT but is expensive, invasive, and prone to inducing complications. Ultrasonography has become the most frequently used noninvasive test for symptomatic DVT because it is highly sensitive and specific in the hands of an experienced examiner. Impedance plethysmography also has been widely used, but recent studies suggest that it is less sensitive than once believed. The radiolabeled 125I-fibrinogen uptake test is no longer available because of concerns about the transmission of blood-borne pathogens. Current thermographic techniques have relatively high sensitivity but poor specificity for DVT. Magnetic resonance imaging and computed tomography are useful adjunctive tests, but their use is limited by cost and availability. D-dimer whole-blood testing may prove to be a rapid and convenient means of ruling out the diagnosis of DVT at the bedside, but further study is needed. When used alone, none of the noninvasive methods is sufficiently sensitive for the evaluation of asymptomatic patients. The diagnostic strategy used should be based on whether the patient is symptomatic or asymptomatic, whether the event is a first one or is recurrent, and a careful clinical assessment. Accurate diagnosis of deep vein thrombosis relies on both testing and patients assessment. SN - 1079-2082 UR - https://www.unboundmedicine.com/medline/citation/9117794/Diagnosis_of_deep_vein_thrombosis_ L2 - https://academic.oup.com/ajhp/article-lookup/doi/10.1093/ajhp/54.1.66 DB - PRIME DP - Unbound Medicine ER -