A 35-year-old male patient presented to the clinic with a history of slight pain and redness in the right thigh after a non-stop flight from Singapore to New York. A limited point-of-care-ultrasound exam was performed bilaterally in the lower extremities. The following video was obtained at the right sapheno-femoral junction. The left image in the video shows the SFJ without compression and the right image in the video shows the compression test performed.

Based on the ultrasound finding what is the diagnosis?  

A. There is no evidence of a DVT in the common femoral vein.

B. There is evidence of a DVT in the common femoral vein (non-compressible common femoral vein seen).

C. There is a thrombus present only in the greater saphenous vein only and the common femoral vein is fully compressible.

The answer is B, there is evidence of a DVT in the common femoral vein (non-compressible common femoral vein seen).

Explanation

The image on the left shows the common femoral vein and the greater saphenous vein without compression. On the right we see that the greater saphenous vein (superficial vein) is compressed. However, the common femoral vein is not full compressible. An echogenic thrombus is also seen in the common femoral vein (seen more clearly on compression). The gold standard is non-compression of the deep vein on B-mode imaging.