The primary diagnostic tool for a phlebologist, (vein specialist), is the ultrasound machine. Ultrasound involves exposing the area in question, (most often the lower extremities), to high-frequency sound waves to produce pictures. Because ultrasound images are captured in real-time, they not only show the position and size of the vessels below the skin not seen with the naked eye, but also the movement and direction of blood flowing through these vessels. A useful "vein map" is then made to diagnose your specific vein problem(s) and determine the best treatment plan for you. At Vein Institute of the Desert, this exam is done free of charge during the initial consultation by Dr. Joan Warren, a Diplomate of the American Board of Phlebology and a Registered Phlebology Sonographer, (RPhS).
While handheld doppler can provide good clues, clinical examination with duplex ultrasound has been the gold standard for the diagnosis of varicose veins for twenty years. However,. ultrasound results are VERY operator-dependent, so make sure the ultrasonographer has experience in venous studies and is certified (RVT) by the ARDMS or the ACP. Xrays are rarely needed.
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