Ultrasound Scan:
Upper Limb
Deep Vein Thrombosis (DVT) 

Deep vein thrombosis is the development of a blood clot within the deep vein system.

​

The upper limb deep vein system includes the internal jugular vein, subclavian vein, axillary vein, brachial vein, radial and ulnar veins.

This scan typically takes between 15-20 minutes to complete.

​

The purpose of this ultrasound is to assess for blood clots (DVT). This ultrasound requires direct contact with your skin. A DVT scan can be done to asses for blood clots in the leg, arm and abdomen (iliocaval) veins.

The purpose of this ultrasound is to assess for blood clots (DVT and SVT). This ultrasound requires direct contact with your skin. The scan starts at wrist and we assess the veins all the way up to your neck. The upper arm and forearm can be scanned either with you laying down or sitting up. We will require you to remove your jumper and long sleeve shirt; sometimes we are able to scan around short sleeve shirts depending on the situation however we will provide you with a disposable gown. We will need to periodically compress the area we are looking at to assess for DVT and SVT. We will ask for you to lie down on the examination bed to assess the neck.

Ultrasound is the preferred imaging modality for arm DVT due to its non-invasiveness, safety, and accuracy in detecting blood clots. It provides real-time imaging and enables healthcare professionals to visualise the affected veins and make informed decisions regarding treatment and management.Arm deep vein thrombosis (DVT) ultrasound scans are performed to assess and diagnose the presence of a blood clot in the deep veins of the arm. Here are the reasons why arm DVT ultrasound scans are done:

Diagnostic tool

Ultrasound is a non-invasive imaging technique used to visualise the veins and assess blood flow. It is the primary diagnostic tool for detecting arm DVT. The ultrasound scan can identify the presence, location, and extent of the blood clot in the deep veins of the arm.

Confirmation of clinical suspicion

Arm DVT ultrasound scans are performed when there is clinical suspicion of a blood clot, based on symptoms such as arm swelling, pain, or tenderness. The scan helps confirm or rule out the presence of DVT and guides further management.

Evaluation of thrombus progression

Ultrasound scans may be performed serially over time to monitor the progression of the blood clot. This helps healthcare professionals assess the effectiveness of treatment and determine if the clot is growing or resolving.

Assessment of vein patency and blood flow

Ultrasound scans can evaluate the patency of the veins and assess blood flow. This information is important in determining the severity and impact of the clot on the arm's venous system. It also aids in identifying potential complications, such as venous obstruction or damage.

Guidance for treatment decisions

The findings from the ultrasound scan guide treatment decisions for arm DVT. The scan helps determine the need for anticoagulant therapy, the duration of treatment, and the possibility of further interventions, such as catheter-directed thrombolysis or placement of a vena cava filter.

Follow-up monitoring

After initial diagnosis and treatment of arm DVT, ultrasound scans may be performed periodically to monitor the resolution of the clot, assess vein health, and identify any recurrence or new clot formation.

Deep vein thrombosis (DVT) in the arm veins, also known as upper extremity deep vein thrombosis, is less common than DVT in the leg veins. The risk factors for arm vein DVT are generally similar to those for DVT in the legs, although there are some specific factors associated with arm vein DVT. Here are common risk factors for arm vein DVT:

Central venous catheter

The presence of a central venous catheter, which is a thin tube inserted into a large vein in the arm or chest, increases the risk of arm vein DVT. This is particularly true if the catheter remains in place for an extended period or if there are other risk factors present.

Arm or shoulder injury/surgery

Trauma, fractures, or surgeries involving the arm or shoulder can disrupt the normal blood flow and increase the risk of DVT.

Cancer and its treatments

Certain cancers, such as those affecting the breast or lymphatic system, increase the risk of arm vein DVT. Additionally, cancer treatments like chemotherapy can affect blood clotting and contribute to DVT formation.

Thrombophilic conditions

Inherited or acquired conditions that make blood more prone to clotting, such as factor V Leiden mutation, prothrombin gene mutation, or deficiencies in natural anticoagulants like protein C, protein S, or antithrombin, can increase the risk of arm vein DVT.

Hormonal factors

The use of combined hormonal contraceptives (such as birth control pills) and hormone replacement therapy can slightly increase the risk of arm vein DVT, similar to leg vein DVT. The estrogen component in these hormonal therapies is thought to contribute to increased clotting risk.

Chronic medical conditions

Certain medical conditions, such as heart failure, inflammatory bowel disease, or autoimmune disorders, can increase the risk of DVT in both the arm and leg veins.

Age

Advanced age is a general risk factor for DVT, including arm vein DVT.

Immobility

Prolonged immobilisation or restricted arm movement, such as during long-distance travel or after a stroke, can increase the risk of arm vein DVT.

It's important to note that while these risk factors increase the likelihood of arm vein DVT, not all individuals with these factors will develop the condition. If you have concerns about your risk of arm vein DVT or if you experience symptoms such as arm swelling, pain, or redness, it is advisable to consult a healthcare professional for evaluation and appropriate management.

Arm vein deep vein thrombosis (DVT) refers to the formation of a blood clot in the deep veins of the arm. The symptoms of arm vein DVT can vary, and some individuals may not experience any symptoms at all. However, when present, the following symptoms may be observed:

Arm swelling

Swelling in the affected arm is a common symptom of arm vein DVT. The swelling may be localised to a specific area or involve the entire arm. It can be mild to severe, and the affected arm may appear larger than the unaffected arm.

Arm pain or tenderness

Pain or tenderness in the arm is another common symptom. The pain may be constant or intermittent, and it can range from mild discomfort to severe pain. The affected arm may feel sore or tender to the touch.

Redness and warmth

The skin over the affected area may appear red or have a reddish-purple discolouration. The arm may feel warm to the touch due to inflammation and increased blood flow caused by the clot.

Visible veins

In some cases, the veins in the affected arm may become more visible or prominent. This may be due to increased blood flow in superficial veins as a result of the clot blocking the deep veins.

Arm heaviness or fatigue

Individuals with arm vein DVT may experience a sense of heaviness, achiness, or fatigue in the affected arm. This can be attributed to the impaired blood flow and increased pressure caused by the clot.

It is important to note that these symptoms are not specific to arm vein DVT and can also be seen in other conditions. If you are experiencing any of these symptoms or have concerns about arm vein DVT, it is recommended to seek medical attention.

If we find a DVT we will advise you of this finding at the time of your scan. We will ask you to wait while we contact your referring doctor to find out what they would like to do. Depending on the location of the blood clot usually determines whether treatment is required or not. In most cases, surveillance scans to keep an eye on any changes will be organised by your doctor. Your doctor may or may not organise a script for blood thinning medication. In rare cases we may advise you to present to the emergency department of your local hospital. If your referring doctor would like to see you on the same day as your scan or we request you attend the emergency department, we will provide you with a printed version of the ultrasound worksheet and written report so you are able to show this to any healthcare provider you may end up seeing. The worksheet and report will be sent to your referring doctor before you leave our rooms as well.

The treatment for arm deep vein thrombosis (DVT) aims to prevent the blood clot from growing, minimise the risk of complications, and promote the resolution of the clot. The specific treatment approach depends on factors such as the size and location of the clot, the presence of symptoms, and individual patient considerations. Here are common treatment options for arm DVT:

Anticoagulant medication

The primary treatment for arm DVT involves the use of anticoagulant medications, also known as blood thinners. These medications help prevent the blood clot from enlarging and lower the risk of new clots forming. Anticoagulants may include injectable medications (such as low molecular weight heparin) followed by oral anticoagulants (such as warfarin or direct oral anticoagulants). The duration of anticoagulation treatment varies depending on factors such as the extent of the clot and the underlying cause of DVT.

Thrombolysis

In some cases, especially if the clot is extensive or causing severe symptoms, thrombolysis may be considered. Thrombolysis involves the administration of clot-dissolving medications (thrombolytics) directly into the clot. This treatment aims to rapidly dissolve the clot and restore blood flow. Thrombolysis is generally reserved for selected cases due to the increased risk of bleeding associated with this treatment.

Vena cava filter placement

In certain situations, such as when there is a high risk of the clot traveling to the lungs (pulmonary embolism) or if anticoagulation is contraindicated, a vena cava filter may be placed. The filter is a small device inserted into the vena cava, the large vein that returns blood from the body to the heart. It catches blood clots before they reach the lungs, reducing the risk of pulmonary embolism.

Arm elevation and compression

Elevating the affected arm and using compression garments or compression stockings can help reduce arm swelling and improve blood flow. This conservative approach is often used as an adjunct to other treatments.

Follow-up care and monitoring

Regular follow-up appointments are important to monitor the progress of the clot, assess response to treatment, and adjust therapy as needed. Imaging studies, such as repeat ultrasound scans, may be performed to evaluate the resolution of the clot and assess the health of the veins.