A patient presents with calf and ankle edema and mild discomfort but negative CW studies. What additional test might be useful?

When a patient presents with calf and ankle edema alongside mild discomfort, and the continuous wave (CW) Doppler studies yield negative results, it is important to consider a non-invasive imaging technique to further investigate the underlying cause of the symptoms. Ultrasound (US) imaging is particularly useful in this context for several reasons.

First, ultrasound can assess the venous system for the presence of deep vein thrombosis (DVT), which may not always be detected by CW Doppler studies, especially in cases of subclinical or small thrombi. It can also evaluate for valvular insufficiency or other venous abnormalities that could contribute to the edema.

Additionally, ultrasound is advantageous due to its availability, rapid execution, and ability to provide real-time imaging. It allows for the visualization of both anatomical and pathological changes in the venous structures, making it a practical choice when exploring vascular issues related to swelling and discomfort.

While CT angiography and magnetic resonance imaging can provide detailed images of the vascular structures, they are often more invasive or time-consuming compared to ultrasound and are typically reserved for cases where more complex issues are suspected. An X-ray is limited to bony structures and wouldn’t provide useful information on venous or soft tissue conditions, which are more relevant