Diagnosis of Venous Disease

Upon your arrival to The Vein Clinic you will be asked to fill out a health questionnaire regarding your overall health and symptoms, especially symptoms related to your legs. This questionnaire will then be reviewed with you by the clinic physician.


Color Doppler ultrasound showing normal upward flow of blood in a vein with the patient lying down.

Physical examination is performed to assess varicose veins as well as any other physical signs that may be indicative of leaking veins or blood clots within the veins of the legs, such as: skin discoloration, swelling, warmth, tenderness to touch, changes in skin texture or ulceration. Examinations may be performed both lying down and with the patient in the standing position to evaluate changes in the appearance of the veins and positional changes in coloration of the legs.


Color Doppler ultrasound performed with the same patient now standing up demonstrates abnormal blood flow in the same vein with blood now flowing back down the leg due to a leaking venous valve (venous insufficiency).

If patient history and physical examination are felt to be consistent with venous leakage or with venous clot formation, and treatment is contemplated by the patient and The Vein Clinic physician, a duplex ultrasound examination is usually performed. This painless and non-invasive test typically takes about 30-40 minutes and is specialized to allow the physician to visualize blood flow direction within the veins and any clot formation within veins which must be addressed during treatment, in order to assure the best possible treatment outcome.


Venogram reveals clot in a large vein in the upper leg (arrow).

Occasionally, if there is concern about clot formation or leaking veins in the pelvis, where visualization may be difficult with ultrasound, a venogram may be performed. This relatively quick procedure is usually performed in the interventional radiology suite of the hospital proper and involves placement of a small needle in the vein at the top of one of the legs. X-ray contrast is injected through the needle or a small IV catheter and x-rays are taken. The x-ray contrast will allow blood flow to be seen and will identify clots in the veins where contrast is not able to flow.