Diagnosis of Deep Vein Thrombosis

Deep venous thrombosis symptoms are shared by many other conditions and diagnosis may be difficult, sometimes the first manifestation may even be the symptoms of pulmonary embolism. Depending on your medical history, your doctor will perform a thorough physical examination and order an imaging test of the veins of the affected leg to rule in (or rule out) DVT.

Be sure to let your doctor know if you have had any symptoms, such as those listed above. Imaging tests include:

Venous Ultrasound (Duplex or Triplex)

Venous Ultrasound (Duplex or Triplex) is simple, fast, non-invasive and accurate in the diagnosis of venous thrombosis of the legs.

This test is less sensitive in finding blood clots that are very deep inside the body (pelvis-abdomen).

It is also used to follow up the progress of the DVT and assess the severity of the resulting chronic venous insufficiency.

A skilled person is required to obtain accurate results.

Computed Tomography Venography (CTV)

Computed Tomography Venography (CTV) is a very accurate study for the diagnosis of large central veins' DVT (pelvis-abdomen) but not for the smaller veins of the leg.

It is very accurate for the diagnosis of pulmonary embolism. This comes at the cost of the need for radiation and intravenous dye (iodinated contrast) that may be harmful for the kidneys, especially in patients with impaired renal function.

CT scans are not ordered routinely.

Magnetic Resonance Venography (MRV)

Venography

Venography

Venography is an invasive imaging study done in a surgical environment as it requires venous access through a groin or behind the knee puncture.

It requires radiation and intravenous contrast. In contemporary practice, it is not routinely recommended for diagnosis. It will eventually be used as part of your treatment if clot busters' (thrombolysis) are going to be used for your treatment.

If your doctor suspects that an inherited disorder could be causing the clots, he or she may conduct a series of blood tests (hypercoagulable workup).

This may be important if you have repeated blood clots, unusual location of the clots or a strong family history.