Thrombophlebitis: diagnostic techniques.

A review of the extensive literature on the diagnosis of deep vein thrombophlebitis (DVT) is presented. DVT affects approximately 10% of all patients with superficial thrombophlebitis. Many authors have shown that the clinical finding of DVT are unreliable. Although pulmonary emboli are relatively frequent in all patients with calf DVT, these emboli are generally not associated with clincial events. Venography is the "gold standard" of diagnostic tests, but it is too cumbersome to be practical as a screening procedure. Radioisotope-labeled fibrinogen is reasonable accurate in diagnosing calf DVT, but much less so in proximal lesions. The results of Doppler ultrasound and impedance plethysmography (IPG) agree with those of venography in 90% of the cases of proximal DVT.