FOLLOW‐UP OF PATIENTS WITH SUSPECTED VENOUS THROMBOSIS BUT NEGATIVE RADIONUCLIDE VENOGRAPHY

Abstract

SUMMARY A retrospective review of the outcome of patients presenting to one district general hospital with suspected deep vein thrombosis (DVT) but normal radionuclide venogram. Of 387 scans, 141 (36%) were reported as positive, 81 (21%) as equivocal, and 165 (43%) as negative. The casenotes of 150 (91%) of those with negative scans were reviewed of which 124 were performed as part of the investigation of suspected DVT. During the next 3 months there were 13 DVTs and 7 with pulmonary emboli in this group, 4 of the latter proving fatal (confirmed at postmortem in 3). From a review of the initial clerking, the pre‐venogram likelihood of DVT was graded as low in 54 (43%), medium in 23 (18%), and high in 45 (36%). DVT or PE occurred in none of those with a low probability, 9% of those with medium, and 38% of those with high probability. The results suggest that radionuclide venography is insufficient to exclude DVT when suspected clinically.