The Deep Vein Thrombosis: Clinic and Diagnosic Strategies

The clinical diagnosis of DVT is not accurate: it has, in fact, a low sensitivity/specificity because even extended thrombosis may be clinically silent and symptoms/signs of DVT are also present in different diseases.

Early and reliable diagnosis, however, is required: the patient with DVT must be treated urgently and properly to prevent pulmonary embolism, recurrent DVT and to prevent post-thrombotic syndrome.

In the case of suspected DVT the diagnostic strategies are different depending on the type of patient (ambulatory or hospitalized, symptomatic or asymptomatic). In particular, the diagnostic strategies include: the determination of the pretest clinical probability (Wells score), the D-dimer test, and the ultrasound diagnosis.

In this lesson the diagnostic strategies in different types of patients will be presented together with the role, within the different algorithms, of the simplified compression ultrasound (s-CUS) and of the complete compression ultrasound (c-CUS)/complete ecocolor Doppler study.

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