Venography is a valuable examination procedure in the assessment of swelling and primary venous disease of the lower extremities. Utilization of the examination has been handicapped by technical problems created by the conditions one wishes to evaluate. Percutaneous cannulation of a satisfactory vein may be impossible in the presence of edema, induration, or ulceration. Under such circumstances, surgical exposure is difficult and the vein isolated may be unsatisfactory because of previous thrombosis. Opacification of the deep venous system, following injection of contrast material into a superficial vein, is accomplished by shunting the contrast agent by tourniquet occlusion of the superficial system. Distinguishing between disease of the deep venous system and incomplete shunting of contrast due to faulty placement of the tourniquet may be extremely difficult. Under such circumstances, identification of perforating veins is handicapped. These problems are eliminated by the use of intraosseous venography. The intraosseous site of injection is
Wegner GP, Flaherty TT, Crummy AB. Intraosseous Lower Extremity Venography. Arch Surg. 1969;98(1):105–110. doi:10.1001/archsurg.1969.01340070123028
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