Deprecated: Implicit conversion from float 213.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 213.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 213.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 213.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 213.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 213.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 213.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 213.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 247.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 247.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 247.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Warning: imagejpeg(C:\Inetpub\vhosts\kidney.de\httpdocs\phplern\27385941
.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 HSS+J
2016 ; 12
(2
): 132-6
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
Duplex Ultrasonography Has Limited Utility in Detection of Postoperative DVT
After Primary Total Joint Arthroplasty
#MMPMID27385941
Vira S
; Ramme AJ
; Alaia MJ
; Steiger D
; Vigdorchik JM
; Jaffe F
HSS J
2016[Jul]; 12
(2
): 132-6
PMID27385941
show ga
BACKGROUND: Duplex ultrasound is routinely used to evaluate suspected deep venous
thrombosis after total joint arthroplasty. When there is a clinical suspicion for
a pulmonary embolism, a chest angiogram (chest CTA) is concomitantly obtained.
QUESTIONS/PURPOSES: Two questions were addressed: First, for the population of
patients who receive duplex ultrasound after total joint arthroplasty, what is
the rate of positive results? Second, for these patients, how many of these also
undergo chest CTA for clinical suspicion of pulmonary embolus and how many of
these tests are positive? Furthermore, what is the correlation between duplex
ultrasound results and chest CTA results? METHODS: A retrospective chart review
was conducted of total joint replacement patients in 2011 at a single
institution. Inclusion criteria were adult patients who underwent a postoperative
duplex ultrasonography for clinical suspicion of deep venous thrombosis (DVT).
Demographic data, result of duplex scan, clinical indications for obtaining the
duplex scan, and DVT prophylaxis used were recorded. Additionally, if a chest CTA
was obtained for clinical suspicion for pulmonary embolus, results and clinical
indication for obtaining the test were recorded. The rate of positive results for
duplex ultrasonography and chest CTA was computed and correlated based on
clinical indications. RESULTS: Two hundred ninety-five patients underwent duplex
ultrasonography of which only 0.7% were positive for a DVT. One hundred three
patients underwent a chest CTA for clinical suspicion of a pulmonary embolism
(PE) of which 26 revealed a pulmonary embolus, none of which had a positive
duplex ultrasound. CONCLUSION: Postoperative duplex scans have a low rate of
positive results. A substantial number of patients with negative duplex results
subsequently underwent chest CTA for clinical suspicion for which a pulmonary
embolus was found, presumably resulting from a DVT despite negative duplex
ultrasound result. A negative duplex ultrasonography should not rule out the
presence of a DVT which can embolize to the lungs and thus should not preclude
further workup when clinical suspicion exists for a pulmonary embolus.