Diagnostic management of clinically suspected acute deep vein thrombosis

Summary Deep vein thrombosis (DVT) is a common disease that may lead to potentially fatal complications, such as pulmonary embolism. In the past decades several diagnostic tools and algorithms for DVT have been studied. Currently the combination of a clinical decision rule, D‐dimer testing and compr...

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Bibliographic Details
Published in:British journal of haematology 2009-08, Vol.146 (4), p.347-360
Main Authors: Tan, Melanie, Van Rooden, Cornelis J., Westerbeek, Robin E., Huisman, Menno V.
Format: Article
Language:English
Subjects:
Algorithms
Biological and medical sciences
Blood and lymphatic vessels
Cardiology. Vascular system
clinical decision rule
deep vein thrombosis
diagnosis
Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous
D‐dimer test
Fibrin Fibrinogen Degradation Products - analysis
Hematologic and hematopoietic diseases
Humans
Magnetic Resonance Imaging
Medical sciences
Risk Assessment - methods
Tomography, X-Ray Computed
Ultrasonography
Venous Thrombosis - diagnosis
Venous Thrombosis - diagnostic imaging
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Summary:Summary Deep vein thrombosis (DVT) is a common disease that may lead to potentially fatal complications, such as pulmonary embolism. In the past decades several diagnostic tools and algorithms for DVT have been studied. Currently the combination of a clinical decision rule, D‐dimer testing and compression ultrasonography has proved to be safe and effective for the diagnosis of DVT in the lower extremities. Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) can be useful as additional or secondary imaging modalities. This review will discuss the elements currently used in making the clinical diagnosis of DVT. These elements include clinical decision rules and D‐dimer testing, different imaging investigations and the appropriate use of these within diagnostic algorithms in patients with clinically suspected DVT. Although current knowledge of the options available to diagnose DVT of the lower extremities is well established, there are still unresolved issues, including the optimal diagnosis of recurrent DVT and distal DVT. Furthermore, the diagnosis of DVT of the upper extremities will be discussed, including the different imaging modalities and the limitations of these techniques.
ISSN:0007-1048
1365-2141
DOI:10.1111/j.1365-2141.2009.07732.x