[Rational diagnosis in phlebologic practice].

Venous diseases are of extraordinary sociomedical and socioeconomic relevance. They are a daily problem in general practice and require careful diagnostic clarification and exact definition with regard to differential diagnosis. In the diagnosis of important venous diseases Doppler sonography must always be carried out after the case history has been taken and a physical examination has been performed. It allows a relatively fast, functionally orientated and differentiated assessment of all venous diseases of the lower and upper extremities and does not involve any risk. At present, it cannot be replaced by any other method either in general or in clinical practice, and also serves as an indication for phlebography for example. Duplex sonography can supplement Doppler ultrasonography significantly, but this examination is still very expensive. There are fundamental sources of error in photoplethysmography and this technique has considerable limitations. It never can replace Doppler ultrasonography. Its only well-founded application - besides a general determination of a more pronounced venous transport disturbance - is to test the haemodynamic effect of eliminating important venous insufficiency points as preparation for invasive forms of therapy. The kind of examination shown here offers the best prerequisites for rational diagnosis in phlebological practice.