Leg pain can be indicative of venous disorders without any signs of varicose veins. Vein-induced leg symptoms are typically associated with swelling of the legs. Characteristic symptoms include diffuse, bilateral sensation of swelling, constriction and unrest. These symptoms are hardly discernible in the morning but are marked in the evening, especially after sitting or standing for prolonged periods at work, or following exposure to intense heat. These symptoms can be alleviated by elevating the legs, walking around, and wearing compression stockings.

 

The symptoms of acute thrombosis can be interpreted as compartment syndrome. Pain is localised in the calf and particularly intense while standing and walking.

 

In proven chronic venous insufficiency, additional symptoms are found, such as local pain due to inflammation, pruritus in presence of statis eczema, and muscle pain during effort in case of venous stasis.

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Evaluation and Examination

 

A comprehensive evaluation, that includes a medical history, physical examination by a qualified physician, and an ultrasound study by a trained sonographer, are necessary to diagnose the problem and any underlying conditions.

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The following diagnostic procedures may be used to diagnose chronic venous insufficiency:

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Duplex Ultrasound

A vascular ultrasound procedure is performed to assess blood flow and the structure of the leg veins. The term 'duplex' refers to two modes of ultrasound: Doppler and B-mode. The B-mode transducer (like a microphone) obtains an image of the blood vessels of interest. The Doppler probe within the transducer measures the velocity and direction of blood flow within the vessel.

 

Magnetic Resonance Venography (MRV)

This is a diagnostic procedure utilising a combination of a large magnet, radio frequencies, and a computer to produce detailed images of body and structures. An MRV uses magnetic resonances technology and intravenous contrast dye to visualise the veins. Contrast dye causes the blood vessels to appear opaque on the x-ray, enabling the physician to visualise the blood vessels being studied. MRV can also help detect causes of leg pain other than vein problems.