Diagnosis of deep vein thrombosis, an overview.

Because clinical signs and symptoms are unreliable the diagnosis of deep vein thrombosis (DVT) should be objectified. Advantages and disadvantages of contrast venography, plethysmography, ultrasound techniques, fibrinogen leg scanning, computer-assisted tomography, magnetic resonance imaging and blood tests are discussed. In patients with a first event of suspected DVT non-invasive methods like serial plethysmography or ultrasound testing are sensitive and specific enough to make a treatment decision. It is safe to withhold anticoagulants if the test remains normal within 1 week. In patients with suspected recurrent DVT new non-invasive techniques are being tested, but up to now the definitive objective diagnostic test continues to be contrast venography. In first period as well as in recurrent DVT D-Dimer testing could be an additional test to exclude active thromboembolism.