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The use of ultrasonography in a medical application was first used in the late 1940s in the United States. This use was soon followed in other countries with further research and development being carried out. The first report on Doppler ultrasound as a diagnostic tool for vascular disease was published in 1967–1968.
Invasive venography can be used in patients who may require surgery or have suspicion of venous stenosis. Other modalities that may be employed are: ankle-brachial index to exclude arterial pathology, air or photoplethysmography, intravascular ultrasound, and ambulatory venous pressures, which provides a global assessment of venous competence.
Medical ultrasound includes diagnostic techniques (mainly imaging techniques) using ultrasound, as well as therapeutic applications of ultrasound. In diagnosis, it is used to create an image of internal body structures such as tendons, muscles, joints, blood vessels, and internal organs, to measure some characteristics (e.g., distances and velocities) or to generate an informative audible sound.
Lower limb venography is indicated in deep vein thrombosis, oedema with unknown cause, and congenital abnormality of the venous system. Less frequently it is used to demonstrate the incompetent valves of perforating veins. Doppler ultrasound is preferable rather than venography to access the competence of the veins.
Unlike arterial ultrasonography, venous ultrasonography is carried out with the probe in a transversal position, (perpendicular to the vein axis), displaying cross-sections of the veins. [4] All collateral veins are better detected this way, including perforator veins, but of most importance is the detection of venous thrombosis.
On inspection the clinician looks for signs of: trauma; previous surgery ()muscle wasting/muscle asymmetry; edema (swelling) erythema (redness); ulcers – arterial ulcers tend to be on the borders / sides of the foot, neuropathic ulcers on the plantar surface of the foot, venous ulcers tend on be on the medial aspect of the leg superior to the medial malleolus.
Weakened Venous valves: these are crucial towards ensuring upward flow to the heart from the lower extremities. If weakened, they may fail to close properly which leads to backwards blood flow/blood pooling. This can lead to slower blood flow in the veins. [8] Ultrasonography-Doppler ultrasound
Major surgery and trauma increase risk because of tissue factor from outside the vascular system entering the blood. [62] Minor injuries, [63] lower limb amputation, [64] hip fracture, and long bone fractures are also risks. [9] In orthopedic surgery, venous stasis can be temporarily provoked by a cessation of blood flow as part of the ...