Venous wall thickness: A key diagnostic clue in Behçet's syndrome

Behçet's syndrome (BS) is a variable vessel vasculitis that can present with vascular involvement in up to 40% of cases. Vein involvement is more prevalent in the early stages of the disease, particularly in young men. In recent years, it has been determined that an increase in venous wall thickness (VWT) can be detected even in the subclinical stages. In this scenario, Doppler ultrasound has emerged as a potential diagnostic tool because it is quick, noninvasive, widely available, and does not require the use of a contrast agent. Furthermore, this technique provides information on vascular wall inflammation and allows dynamic and real-time assessment of the involved vessels by measuring the VWT, particularly of the common femoral vein (CFV), with good diagnostic accuracy. Therefore, Doppler ultrasound could play an important role in the diagnosis of BS, which constitutes a substantial clinical challenge, given its wide spectrum of presentation, the absence of specific symptoms, and the lack of definitive confirmatory tests. We present a narrative review of the literature from the various studies available to date on this topic in order to attempt to answer the question of whether measuring VWT is useful for establishing a diagnosis of BS.