The role of ultrasonography in thromboembolic disease management in the orthopaedic patient.

Deep venous thrombosis (DVT) is a well-recognized contributor to increased morbidity and mortality following trauma and elective musculoskeletal procedures. Ultrasound has become a popular noninvasive modality for use in the detection of symptomatic DVT. However, its use as a screening tool in asymptomatic or postoperative patients has been questioned. The reliability of ultrasound rests mainly in the ability of the technicians performing the exam. Ultrasound has been shown to be less reliable in identifying asymptomatic calf thrombi; in institutions where ultrasound DVT surveillance is not performed routinely, the technique suffers from inadequate sensitivity to be utilized for routine screening purposes. Recognition of patients at high risk for DVT, along with an understanding of the limitations of ultrasound, will allow for appropriate clinical application of this modality.