Having had two separate exams done, one showed deep vein reflux and one showed nothing. I have no superficial varicose veins and no swelling, but do have pain in my legs and burning in my feet on and off. Any suggestions in terms of the next steps I should take? I am confused. Thx.
Duplex ultrasound can reliably detect reflux when performed with the patient standing. If your examination was done while you were lying down, it is not accurate. The most important issue is whether the examiner is
experienced. It is certainly possible to have only deep vein reflux.
Published on Jul 11, 2012
It is possible that you have faulty valves in your deep system without having superficial reflux. Have you had arterial studies done on your legs? Or, have you talked to a neurologist? I would recommend finding an interventional radiologist (IR) to have another ultrasound and consultation. They are the best in these types of diagnosis. It is not a difficult ultrasound to determine reflux in veins, so it is surprising that two different exams had two different results. That's why I'm recommending an IR to see and have another ultrasound. If there isn't any deep vein insufficiency, then they will help with referrals.
Published on Jul 11, 2012
Yes, that is common, but it is likely that the burning sensation in your feet is not caused by veins. I would consider a check-up with a neurologist or someone to check on the nerves in your legs.
Published on Jul 11, 2012
I can imagine the dilemma you find yourself in. Have your primary care physician order a Duplex ultrasound from the local hospital or vascular lab.
Published on Jul 11, 2012
It is not common to have deep vein reflux without any superficial varicose veins or swelling, but it can happen. Remember that the criteria for deep vein reflux are different than for superficial veins (up to 1000 msec is normal). The waveform obtained during the Doppler exam may reveal a reason for the abnormal flow, or a venogram may be needed to further investigate this finding. However, why did you have this exam done? If you are not symptomatic, do not have deep vein thrombosis now and have not had it in the past, then no further therapy or testing may be indicated. I recommend you consult with a knowledgeable vein specialist.
Published on Jul 11, 2012
You may want to get a third duplex exam. If so, make sure he/she is an experienced phlebologist. I suspect from your story that you don't have venous disease. Burning feet is not a usual feature of venous problems. It may be a nerve problem.
Published on Jul 11, 2012
Deep venous reflux occurs more commonly than we expect. The presence of deep venous reflux does not mean that it is symptomatic or needs to be treated. There are many degrees of deep reflux and depending on how extensive it is and what your symptoms are, treatment varies. From what you describe, no treatment seems necessary. Your symptoms do not appear to be due to deep reflux. You may want to be evaluated by a vascular surgeon who could then recommend the proper person to see.
Published on Jul 11, 2012