Deep vein thrombosis: diagnosis of a comon clinical problem.

Ultrasound is recognized as a very accurate first line diagnostic tool when a patient presents with a symptomatic lower extremity suggesting acute venous thrombus. Advantages of ultrasound are that it does not involve using radiation or contrast and can be performed portably, generally with no complications. In many patients, other abnormalities such as Baker's cysts, arterial aneurysms, or hematomas can be detected and can explain the symptoms. Some limitations are that ultrasound is dependent on the skills of the sonographer and is very limited in visualization of iliac and abdominal veins. We are currently investigating computed tomography (CT) venography, which appears to be an accurate alternative, particularly for obese patients or when pelvic or abdominal thrombus is suspected.