Venous thrombosis in patients who have undergone major hip or knee surgery: detection with compression US and impedance plethysmography

Article Abstract:

Blood clots in the deep veins are a frequent complication of major hip or knee surgery. Such clots may not produce symptoms initially and affected patients are often released from the hospital only to suffer more severe consequences later. Ascending venography is an accurate diagnostic technique for detecting such clots, but it is invasive, painful, and expensive. A noninvasive technique for evaluating patients who have undergone hip or knee surgery for these complications is desirable. This study evaluated two techniques, compression ultrasonography (US) and impedance plethysmography (IPG), for such a purpose. US uses high frequency sound waves to produce images of tissues and internal organs. IPG measures changes in volume in blood vessels. Ascending venography was performed on 130 patients, 117 having it performed in both legs, and 13 in one leg. All 130 patients were evaluated with compression US, and 106 were evaluated with IPG. Results of the latter two techniques were compared with those of venography. Venography found clots in 61 legs of 53 patients. Of the 61 clots, 40 were in the calf vein and 21 were in the proximal veins. US was only able to detect 5 of the 40 calf vein clots, but was able to detect 11 of the 21 proximal vein clots. In the 106 patients evaluated with all three techniques, 17 proximal and 36 calf clots were identified. Neither IPG nor US was useful in detecting the calf clots. For the 17 proximal clots, US detected 11 and IPG detected 7. In a group of 65 symptomatic outpatients, both venography and US were performed. Venography found 38 proximal vein clots and US detected 35 of the 38 clots, a much higher rate than that observed in the postsurgical patients. These results indicate that US is more reliable than IPG in identifying proximal vein clots in the leg, but neither method is very effective in detecting deep vein clots. (Consumer Summary produced by Reliance Medical Information, Inc.)

Diagnosis, Complications and side effects, Surgery, Postoperative complications, Impedance plethysmography, Knee, Thromboembolism, Hip, Veins

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Increased renal parenchymal echogenicity in the fetus: importance and clinical outcome

Article Abstract:

Ultrasound (US) imaging uses high-frequency sound waves to produce images of organs and tissues. The echogenicity or ability to produce a reflection of the sound waves varies with types of tissues and with changes in tissue, such as when the tissue is diseased. US-detected changes in renal (kidney) tissue may indicate a number of diseases. It is less clear what increases in the echogenicity of fetal kidney tissue signify. To examine the importance of such findings, the outcomes of 19 fetuses whose results on US were normal except for increases in echogenicity of the kidneys were followed-up. Results from pediatric examinations and further US examinations before and after birth were evaluated. Four of the infants were born healthy and showed no abnormalities on any of the later examinations. Abnormalities were seen on some or all the examinations performed on the remaining 19 cases. In five cases, the fetuses died from kidney abnormalities. The other 10 suffered from varying types of kidney abnormalities. These results indicate that a US finding of increased echogenicity of fetal renal parenchyma is highly indicative that the fetus will be born with some type of kidney abnormality and that the chances that the fetus will not survive are significant. (Consumer Summary produced by Reliance Medical Information, Inc.)

Cases, Fetus, Kidneys, Kidney, Prenatal diagnosis, Prenatal ultrasonography

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