Here’s a brief video from one of the device manufacturers that illustrates the technique of duplex ultrasound in the lower extremity.

Admit it. You’re curious. You order this test for your trauma patients all the time but you’ve never seen it done. It’s simple and noninvasive, but it does require access to all areas to be evaluated. This means that extremities that are casted or splinted, or that have extensive dressings in place may be incompletely evaluated.

The study is called “duplex” because it makes use of two modalities: traditional ultrasound and Doppler ultrasound. Traditional ultrasound is used to view the compressibility of the veins of interest at a number of locations. Doppler measures the speed of blood flow under the probe, and can show areas of sluggish flow.

The following diagram shows the traditional ultrasound technique being used to compress the vein of interest (femoral, popliteal, etc.). Part A shows the probe gently resting over the vessels. Part B shows a fully compressible vein (normal), and Part C shoes partial compression due to the presence of thrombus.

The following diagram shows what the actual ultrasound study looks like. The right side is normal, but the left side shows a venous thrombosis.