Deep vein thrombosis diagnosis specific situations: Difference between revisions
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==Overview== | ==Overview== | ||
The approach to diagnosis of [[DVT]] may be modified in certain situations, where the suspicion is high or there is a recurrent episode. This chapter will discuss these modifications, that have been recommended the American College of Chest Physicians. | The approach to diagnosis of [[DVT]] may be modified in certain situations, where the suspicion is high or there is a recurrent episode. This chapter will discuss these modifications, that have been recommended the American College of Chest Physicians. | ||
===[[CUS]] chosen as the first initial test== | ===[[CUS]] chosen as the first initial test== | ||
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* If negative, repeat [[Deep vein thrombosis ultrasound|ultrasound]] or D-dimer testing should be done in 1 week. | * If negative, repeat [[Deep vein thrombosis ultrasound|ultrasound]] or D-dimer testing should be done in 1 week. | ||
===Positive D-dimer only=== | |||
== | * If the initial D-dimer is positive, but [[Deep vein thrombosis ultrasound|ultrasound]] is negative, a repeat [[Deep vein thrombosis ultrasound|compression ultrasound]] should be performed in 1 week. | ||
===Isolated distal DVT=== | |||
* On identification of an isolated [[DVT]] in the distal calf veins, serial testing is recommended to rule out proximal extension. | |||
===Recurrent [[DVT]]== | |||
Revision as of 16:57, 20 May 2012
Editors-in-Chief: C. Michael Gibson, M.S., M.D. Associate Editor-In-Chief: Kashish Goel, M.D.; Ujjwal Rastogi, MBBS[1]
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Overview
The approach to diagnosis of DVT may be modified in certain situations, where the suspicion is high or there is a recurrent episode. This chapter will discuss these modifications, that have been recommended the American College of Chest Physicians.
=CUS chosen as the first initial test
It is recommended that pretest probability should be computed in each patient to assess the need for further testing. However in certain clinical scenarios (like moderate probability), the clinician may decide to proceed with ultrasound as the first test.
- If positive, then treatment should be started.
- If negative, repeat ultrasound or D-dimer testing should be done in 1 week.
Positive D-dimer only
- If the initial D-dimer is positive, but ultrasound is negative, a repeat compression ultrasound should be performed in 1 week.
Isolated distal DVT
- On identification of an isolated DVT in the distal calf veins, serial testing is recommended to rule out proximal extension.