The value of using ultrasound to rule out deep vein thrombosis in cases of cellulitis
© 2017 Society of Hospital Medicine
RECOMMENDATIONS
Do not routinely perform ultrasound to rule out concurrent DVT in cases of cellulitis.
Consider compression ultrasound if there is a history of VTE; immobility; thrombophilia, CHF, and CVA with hemiparesis; or trauma and recent surgery. Also consider it for patients who do not respond to antibiotics.
- In cases of cellulitis, avoid use of the Wells score alone or with
D -dimer testing, as it likely overestimates the DVT risk.
CONCLUSION
The current evidence shows that, for most patients with cellulitis, routine ultrasound testing for DVT is unnecessary. Ultrasound should be considered for patients with potent VTE risk factors. If symptoms do not improve, or if they worsen despite use of antibiotics, clinicians should be alert to potential anchoring bias and consider DVT. The Wells clinical prediction rule overestimates the incidence of DVT in cellulitis and has little value in this setting.
Disclosure
Nothing to report.
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