Bilateral lower extremity evaluation of deep venous thrombosis with color flow and compression sonography

Recognition of the accuracy of CUS for diagnosis of DVT has led to increased requests for bilateral lower extremity CUS studies. Compared to unilateral lower limb CUS studies, these examinations are often requested when the clinical suspicion of DVT is less strong. We undertook a 15 month prospective study of bilateral lower extremity CUS examinations to determine the diagnostic yield of positive studies and any correlation with clinical parameters. Eighty-six patients were studied; six patients (7%) had studies positive for acute DVT, and 78 patients (91%) had negative studies. Positive studies did not correlate with clinical parameters except erythema. Concurrently, 23% of unilateral lower limb sonographic studies were positive. Bilateral lower limb CUS is a low yield investigation, which may be indicated in view of the morbidity and mortality associated with DVT and pulmonary embolism.