Scans

Upper Extremities, Venous/DVT Duplex Ultrasound

Indications:

  • Arm pain of questionable aetiology
  • Tight, unilateral, swollen arm
  • Heaviness in the arm, or painful arm
  • Discolouration of the arm
  • Painful, red lump
  • Surveillance of known DVT or superficial venous thrombosis (SVT)
  • Thoracic outlet syndrome (TOS)

PLEASE NOTE: if TOS is suspected, this is an ADDITIONAL study and requires a further 30-45 minutes, to assess the veins and arteries in provocative manoeuvres. Please mention this at the time of booking the ultrasound appointment.

Contraindications and limitations:

  • Extreme arm girth (obesity, extreme musculature, or extreme oedema)
  • Site trauma such as open wounds in the scanning area
  • Casts or dressings that cannot be removed
  • Patients that cannot be adequately positioned.

Patient preparation:

  • Eat breakfast, lunch or a snack within 3 hours prior to attending the ultrasound appointment.
  • Be well hydrated. Please ensure 500ml-1500ml of water has been consumed prior to the ultrasound, unless there is an underlying medical condition, that requires fluid restrictions. Please note: Coffee, tea and alcoholic drinks are dehydrating; these drinks are not included in the 500-1500mls of water. WHY? This increases the blood volumes which allows for improved visualisation of the veins.
  • On the day of the ultrasound, refrain from applying oils or moisturisers to the upper limb

PLEASE BRING RELEVANT, PREVIOUS DIAGNOSTIC REPORTS AND ULTRASOUND WORKSHEETS TO YOUR ULTRASOUND AND DOCTORS APPOINTMENT

What to wear:

Loose-fitting clothes, for example; a loose-fitting top or sleeveless top.

Ultrasound study technique:

Ultrasound is a non-invasive diagnostic study. The patient will lie on a bed, with the head of the bed slightly elevated for comfort. The arm is supported on the bed or on a pillow. Ultrasound gel will be applied to the arm, the axillar (arm pit) and the clavicular region (collar bone region). An ultrasound probe is run over the clavicular region, the axillar and the arm. Moderate pressure, with the scanner head, is applied to the arm and axillar region, segmentally, to compress the veins. The use of colour and spectral Doppler will be used to assess the flow from the neck to the wrist. Images will be obtained, and the results documented on a worksheet.

Ultrasound study time:

20-30 minutes per arm. If TOS is suspected, an additional 20-30 minute per limb, will be required.

Results:

A worksheet can be available, if requested. A formal written report will be available within 24 to 48 hours, following the ultrasound examination, Monday to Friday. If the ultrasound findings demonstrate pathology, which may require urgent attention, the referring Doctor will be notified ASAP following the completion of the ultrasound.