Mohammad Zahid, Mohammad Tahir, Rabeea Sadaf, Mahe Naz Khan, Ishaq Khattak.
Appraisal of clinical features and color flow Doppler studies in diagnosing deep vein thrombosis in clinically suspected cases of DVT.
J Med Sci Jan ;13(2):157-60.

We decided to assess the role of clinical features and colour flow Doppler studies in the diagnosis of deep venous thrombosis. Research Methodology: One-year cross-sectional study at Khyber Teaching Hospital Peshawar was carried out from January 2003 to January 2004. This study included 50-patients, admitted in medical wards of Khyber Teaching Hospital Peshawar, with a clinical suspicion of deep vein thrombosis. All cases had swelling and pain in lower limb/s with or without tenderness and or redness. Patients were selected according to the inclusion and exclusion criteria. In each case Colour flow Doppler Ultrasonography was performed on the whole length of the affected lower limb/s. The clinical features of patients with Doppler positive studies (having deep vein thrombosis) were compared to Doppler negative cases. The final diagnosis was established with the help of Colour Flow Doppler ultrasonography. Results: Out of 50 patients, 25 had deep vein thrombosis while 2 had post-thrombotic sequellae. 23 patients although had signs and symptoms of deep vein thrombosis but none had venous thrombosis. Patients with all four classical features of DVT have two and half times greater chance of having DVT as compared to those with only two clinical features. This means that the classical features of DVT are sufficiently specific to DVT and when present should prompt investigations for its early diagnosis and treatment. The observed major risk factor in this study was postpartum period, accounting for 26% of the total Doppler proven DVT cases. 37% had DVT of spontaneous origin. All patients with DVT established on colour flow Doppler were started on anticoagulant therapy and all showed improvement in their clinical presentation. Conclusion: Deep vein thrombosis is a clinical condition that can end in a life threatening state, “The Pulmonary Embolism” which can be prevented by a timely diagnosis of DVT. Colour flow Doppler Sonography, the non-invasive technique, alone is enough to diagnose DVT as it has got a high sensitivity and specificity. This offers a clinician the most reliable and accurate method just short of Venography.

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