DEEP VENOUS THROMBOSIS IN ORTHOPEDIC PATIENTS - IMPROVING THE SPECIFICITY OF DIAGNOSIS

MA MCNALLY, George Kernohan, SA CROAL, RAB MOLLAN

Research output: Contribution to journalArticle

Abstract

The diagnosis of deep vein thrombosis after total joint arthroplasty is difficult. The most widely used method of detection is physical examination and selective venography, which are unreliable and expensive even when symptoms and signs are prominent. This study employed computerized strain gauge plethysmography (CSGP) to select symptomatic patients for venography. The incidence of detection by CSGP was increased from 16% to 81.7%. Repeated CSGP also was investigated, but although specificity was further enhanced, it was at the expense of sensitivity. The negative predictive value of the CSGP screening was high and comparable to that of venography and indicates that CSGP is useful in the management of patients with symptoms suggestive of deep vein thrombosis. Computerized strain gauge plethysmography results emphasize the low specificity and poor feasibility of clinical examination and venography. Computerized strain gauge plethysmography is strongly advocated as a selection procedure for invasive venography in total joint arthroplasty patients.
LanguageEnglish
Pages275-280
JournalClinical Orthopaedics and Related Research
Issue number295
Publication statusPublished - Oct 1993

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Plethysmography
Venous Thrombosis
Orthopedics
Phlebography
Arthroplasty
Joints
Signs and Symptoms
Physical Examination
Incidence

Cite this

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title = "DEEP VENOUS THROMBOSIS IN ORTHOPEDIC PATIENTS - IMPROVING THE SPECIFICITY OF DIAGNOSIS",
abstract = "The diagnosis of deep vein thrombosis after total joint arthroplasty is difficult. The most widely used method of detection is physical examination and selective venography, which are unreliable and expensive even when symptoms and signs are prominent. This study employed computerized strain gauge plethysmography (CSGP) to select symptomatic patients for venography. The incidence of detection by CSGP was increased from 16{\%} to 81.7{\%}. Repeated CSGP also was investigated, but although specificity was further enhanced, it was at the expense of sensitivity. The negative predictive value of the CSGP screening was high and comparable to that of venography and indicates that CSGP is useful in the management of patients with symptoms suggestive of deep vein thrombosis. Computerized strain gauge plethysmography results emphasize the low specificity and poor feasibility of clinical examination and venography. Computerized strain gauge plethysmography is strongly advocated as a selection procedure for invasive venography in total joint arthroplasty patients.",
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DEEP VENOUS THROMBOSIS IN ORTHOPEDIC PATIENTS - IMPROVING THE SPECIFICITY OF DIAGNOSIS. / MCNALLY, MA; Kernohan, George; CROAL, SA; MOLLAN, RAB.

In: Clinical Orthopaedics and Related Research, No. 295, 10.1993, p. 275-280.

Research output: Contribution to journalArticle

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