Summary
A uniform, standardised positioning of the patient is one of the requirements for
a reliable standardisation of diagnostic findings and their documentation in colour
duplex ultrasound of the leg vessels. We have endeavoured to present specific arguments
in favour of a differentiated duplex ultrasound of the leg vessels with the patient
supine in contrast to the routine investigation with the patient exclusively in the
upright position. Naturally, the choice of patient positioning – supine, sitting,
standing – depends on the nature of the diagnostic question or findings. In our view,
a more detailed, time-consuming diagnosis of reflux is the domain of the supine investigation.
This also applies to assessing recurrence at the saphenofemoral junction. However,
as large, relevant reflux pathways can normally be adequately visualised and documented
on examination in the standing position, the latter can readily be used to confirm
the indication for large-scale measures to eliminate varices.
When investigating leg arteries, the patient must be as horizontal as possible for
measurement of ankle brachial index. The examination of the lymphatic system with
high-resolution duplex ultrasound is mentioned only briefly because the investigation
raises no special problems related to patient positioning.
Keywords
Duplex ultrasound - diagnostic patient positioning - reflux diagnosis
