Leg DVT pathology

To see scanning technique.

Femoral DVT (Thigh)

Non occlusive DVT in transverse. Flow is demonstated using power doppler ultrasound.

Ultrasound image- The proximal extent of the DVT appears as a mobile tongue of thrombus. Flow is seen surrounding this non occlusive portion.

Ultrasound image- DVT comparison. Normal Right, DVT in left.

Video clips of mobile thrombus in the lower limb.

Ultrasound image- Acute on Chronic thrombosis:

The echogenic older thrombus is seen, with the very hypoechoic underlying acute thrombus. This acute phase is difficult to see on B-mode alone. Compression and colour doppler must be employed to prove/disprove the existence of a DVT.

Ultrasound image- The fusiform dilatation of a venous valve containing thrombus.

Popliteal vein DVT

Popliteal vein DVT in Transverse.

Right ultrasound image is attempted compression.

Ultrasound image- Popliteal vein DVT in longitudinal. A gastrocnemius branch is visible.

Calf Deep Veins (Posterior Tibial Veins & Peroneal veins)

Transverse ultrasound view of the posterior tibial and peroneal veins.

Pre & Post compression.

Transverse mid calf.

Hover mouse over to see the scan plane.

Ultrasound image- Longitudinal calf veins. Split screen, color doppler and B-mode.

A sagittal scan plane for the calf veins.


Thrombosed Posterior tibial veins (highlighted in green when you hover your cursor over the image.

Using color doppler ultrasound, flow is clearly seen in the Peroneal veins (blue) and peroneal artery (red).

Calf muscular vein thrombosis

Abdominal and Pelvic DVT (IVC filter)

It is vital to identify the most proximal extent of the DVT. Follow up into the pelvis.

An IVC filter may be inserted in cases of extensive DVT.

Ultrasoud image- An IVC filter (highlighted in green) centrally in the IVC.

Ultrasoud image- An IVC filter (highlighted in green) centrally in the IVC.

Differential Diagnoses


Ultrasound image- Short saphenous thrombophlebitis.

Ultrasound image- Transverse view of Short Saphenous thrombophlebitis.


Neo-vascularisation of thrombosus via the peri-venous vessels. These vessels are generally too small to see with ultrasound.

Transverse ultrasound view showing one of the feeding vessels.


Ultrasound image- The Semimembranosis-Gastrocnemial bursa (Baker’s cyst): By remembering the name, the anatomical position can be determined to ensure incorrect diagnoses are avoided (For example a popliteal fluid collection associated with a hamstring tear).

Ultrasound image- A Baker’s cyst is subject to: •Haemorrhage (from the knee joint) •Septations (when chronic) •Rupture (causing medial upper calf pain +/- swelling)


Ultrasound image- A calf muscle abscess with drainage needle in position.

Ultrasound image- A medial gastrocnemius tear at the distal musculo-tendinous junction.


Ultrasound image- A calf muscle abscess with drainage needle in position.