C5-2 probe for calf DVT's

Hi,

I was just wondering if other people used a C5-2 probe for imaging calf veins for DVT assessment on difficult cases, e.g. large leg, oedema?

Personally I don't see the problem in using it to diagnose calf DVT's in difficult cases, but have recently become aware that this may not be the general consensus.

What are your opinions/experiences?


Thanks!

Thankfully i don't scan very many DVT's at all (so my opinion may not be that founded)

However, I personally would reach for the low freq probe when depth became an imaging limitation in a large leg.
I'm not sure what would count as a significant reason not to use it

i can see how its useful if you do see flow in vessels that you couldn't see before, but can appreciate that you lose out on resolution.
Also you may then be able to see a dilated vein full of thrombus which was not obvious before.
Maybe its easier to rule out a DVT in these situation where you can see colour flow or confirm a DVT when you see thrombus, but can't report definately report a clear when you don't see anything.
We just sometimes have to say that imaging was too limited and perhaps bring the Pt back in a week.

Besides, some places don't even scan calf veins routinely for a DVT scan

Hi,

I do scan for DVT's within the radiology department and I would also reach for the lower frequency probe to find calf veins in an oedematous leg. My desire to demonstrate patency of calf veins is only tempered by the hospital policy on whether they treat below knee DVT's.
If they don't treat, why waste time finding?? - look for potential extension in roughly 7 days time.

regards

Maggie

At the Royal Oldham we scan a huge number of ? DVT patient's, anything from ward patients to patients from a dedicated DVT outpatient clinic run by specialist nurses in close collaberation with ourselves. We can regularly scan anything from 2 to 10 DVT patients a day. I regularly use the curved array with difficult calf scans, and occasionally in the thigh on very large legs, and I often find it extremely useful. Sometime's swapping from linear to curved is like turning a light on! Whilst some resolution is lost coloufilling can be very good and often you can obtain enough resolution to determine the veins are compressible in cross section.
However if there are any doubts as to the accuracy of the scan they will have a repeat scan in a week's time.
We have always scanned calf veins and they are treated here, and I personally think that is best policy. Having met a young chap in his 20's a few months back who had been assessed for DVT some years previous at a different hospital but only proximal veins to knee level, and pronounced negative, when I scanned him - now with venous ulceration at the ankles - he had extensive old thrombus and deep incompetence throughout his calf veins. He will now have problems for the rest of his life having not been correctly diagnosed and treated. I know I wouldn't want anyone I know to end up in such a position!