DVT: Compression Ultrasound (POCUS)

1. 1

   Patient supine, leg slightly externally rotated. Linear probe (5–12 MHz).

2. 2

   Groin: identify CFV in transverse. It is medial and compressible — artery is lateral and pulsatile.

3. 3

   Apply firm downward pressure — normal vein walls fully touch. Non-compressible = DVT.

4. 4

   Scan femoral vein in mid-thigh with sequential compression every 2cm.

5. 5

   Popliteal vein: flex knee or prone position. Compress transversely from above to below the knee.

6. 6

   Add color Doppler and squeeze calf — confirm augmentation response at each level.

7. 7

   A 2-point compression study (CFV + popliteal) has high sensitivity for proximal DVT in low-risk patients.

• Common femoral vein (CFV)
• Femoral vein (mid-thigh)
• Popliteal vein
• Trifurcation

• Vein compressibility
• Intraluminal thrombus echogenicity
• Doppler flow pattern
• Augmentation

• Always compare to artery — arteries are pulsatile and don't fully compress
• Calf veins require experienced operators

Normal: vein fully compresses (walls touch). DVT: vein non-compressible or partially compressible.