If one has unexplained leg pain and swelling, particularly following trauma, major surgery or prolonged immobilization, tests for thrombophlebitis should be performed. Until recently, it consisted mainly of venography. Venography is a radiological examination in which a contrast substance is injected via a foot vein. The purpose of the exarnination is to visualize by x-rays the deep veins of the legs and establish either the presence or the absence of blood clots. More recently, there has been a shift toward noninvasive methods.
Noninvasive methods are devoid of the discomfort caused by venography.
The two main noninvasive techniques for diagnosing deep vein thrombophlebitis are impedance plethysmography and ultrasound examination. Both these techniques are available at The Montreal General Hospital and many other major university-teaching hospitals. With either method, a complete examination takes approximately 15 minutes. In the case of Dr F., the key to survival would have been the use of preventive measures. Major orthopedic surgery of the leg carnes a relatively high risk of thrombophlebitis and pulmonary embolism.