Varicose veins diagnosis is the most important and the initial approach to the treatment of the disease.
Clinical examination of a patient is of a primary importance in varicose veins diagnosis, as at this stage the overall health status is assessed, further tactics and treatment are determined.
Medical history is of a great importance in diagnosis of veins and vessels and an accurate evaluation of a patient’s state of health. Inadequate medical history taking and examination of a patient can lead to an irretrievable mistake in choosing treatment tactics.
A doctor should find out at what age a patient had the first symptoms of varicose veins, on what parts of his/her body, what causes new enlarged veins appearance in the feet, ankles and thighs. He notes the dates of trophic skin changes, find out about the treatment carried out.
Besides, it is necessary to clarify:
- if a patient had a superficial thrombophlebitis;
- if a patient had swellings in the lower limbs, the degree of these swellings, localization, is the swellings went down after night’s sleep;
- if a patient had a deep vein thrombosis;
- if he/she had erysipelas in the lower limbs, how they developed;
- if a patient had inflammatory changes in the skin, how they developed and how long they were treated;
- if a patient had traumas, bruises , fractures;
- if a patient had surgery on the legs.
The doctor will specify the particular features of a patient’s profession (prolonged standing or seating at work), physical activity, accompanying diseases, if a patient was taking hormones, daily wear features (stretch pants, underwear etc.), if a patient wears corsets.
Physical examination of a patient
A comprehensive physical examination of a patient developing varicose veins gives a sufficient information about the state of superficial and deep veins.
The doctor carries out a full examination of a patient. While a patient is standing or sitting the doctor examines his/her two legs, groin area, chest, abdominal walls, arms, neck, shoulders.
The specialist makes an assessment of limbs: skin color, varicose veins development, localization and severity of varicose veins, telangiectasias, swellings.
After visual inspection of varicose veins, the doctor touches the skin, determines its temperature and humidity.
Ultrasound scan of veins and vessels
If the visual inspection does not give the accurate information about the state of venous system, the ultrasound scan of veins and vessels is required.
The ultrasound scan of veins helps to make an assessment of veins and blood flow.
The method also allows to make an assessment of vein walls. It helps to define the extent of varicose veins, the presence and localization of thrombosis and their size.
The ultrasound scan is carried out in a specially equipped room. The most important characteristic of the room is good illumination. To carry out the scan the doctor uses a special ultrasound machine equipped with special sensors. The specialist examines the image of the scanned vein displayed on the monitor.
Depending on the goals of the examination the ultrasound scan is carried out while a patient is standing or seating. During the scanning the patient should relax muscles to let blood fill the veins. The ultrasound scan should be carried out by a phlebologist or a vascular surgeon who will determine the regimen for varicose veins treatment. The ultrasound report and visual inspection help to predict the development of pathology and to prescribe the most effective treatment.