During a 1-year period, 537 compression ultrasound (CU) examinations were performed in 506 extremities of 485 patients for evaluation of possible deep venous thrombosis (DVT). Decisions regarding therapy were based on the result of this test in both outpatients and inpatients. Doppler ultrasound was also used during the last 7 months of the study, but this procedure did not alter the results obtained with CU alone. Incidental findings (eg, Baker cysts, aneurysms, and lymph nodes) were noted in 42 patients and were thought to be nonthrombotic causes of leg swelling or pain that could not be detected with venography. The reliability and clinical acceptance of CU as a means of diagnosing lower-extremity DVT resulted in a 50% yearly reduction in venography, with a concomitant 130% increase in the number of cases of DVT diagnosed.
Low‐level swirling echoes were noted in scrotal fluid that ultimately proved to be a hydrocele. This sonographic appearance is similar to a hematocele or pyocele and potentially can cause confusion. We evaluated 14 patients with hydroceles and found these swirling echoes in nine. In each of these patients, the echoes were readily apparent with increased gain and were distinguished from artifact by their motion. We analyzed the fluid from one hydrocele and found high protein levels. We propose that protein aggregates account for these echoes. This appearance should not be confused with that resulting from a traumatic or infectious cause.
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