ABSTRACT
Duplex ultrasonography has become widely used in the management of varicose veins and leg ulcers. Several papers have been published in which the efficacy of duplex ultrasonography has been reported without comparison to other modalities of investigation.1-4 Is this investigation essential in all patients with venous disease in the lower limb and are any other tests useful? Plethysmographic tests were commonly used to assess the impairment to venous function but these have been widely abandoned in favor of duplex ultrasonography. These are discussed in more detail in Chapter 11. Vascular surgeons often examine patients with continuouswave (CW) Doppler ultrasound, since this is a simple investigation which may be accomplished in the clinic. Is this sufficient for some patients or should we always arrange for duplex ultrasonography in addition? Clinical examination is very poor in assessing the source of varices, even when performed by an experienced vascular surgeon.5
