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Chapter-04 Evaluation of Varicose Veins

BOOK TITLE: Sclerotherapy in Dermatology

Author
1. K Shilpa
2. DV Lakshmi
3. K Divya Gorur
ISBN
9789352702060
DOI
10.5005/jp/books/18040_5
Edition
1/e
Publishing Year
2018
Pages
12
Author Affiliations
1. Bangalore Medical College and Research Institute, Bengaluru, India, Victoria Hospital, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India, Bangalore Medical College and Research Center, Bengaluru, Karnataka, India
2. Victoria Hospital, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India, Bengaluru, Karnataka, India, Bangalore Medical College and Research Center, Bengaluru, Karnataka, India
3. Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India, Bangalore Medical College and Research Center, Bengaluru, Karnataka, India
Chapter keywords
Varicose veins, chronic venous insufficiency, cough impulse test, tap test, Brodie-Trendelenburg test, modified perthes test, CT, MRI

Abstract

This chapter focuses on the evaluation of varicose veins. Chronic venous insufficiency is a complex and chronic condition, with varied clinical manifestations, etiologies and underlying pathophysiology. A thorough stepwise workup is essential to assess the nature of a patient’s underlying venous disease. This should begin in the clinical setting itself with a careful medical history, physical examination and bedside diagnostic tests. These need to be supplemented by confirmatory diagnostic testing, including duplex ultrasonography, venography, plethysmography and ambulatory venous pressure measurement. Brodie-Trendelenburg test is done to differentiate between perforator and GSV incompetence. The Brodie-Trendelenburg test is highly sensitive for the identification of superficial and perforator reflux (91%), although poorly specific (15%). The test is performed with patient in supine position.

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