Medical Question Re: Ultrasound Check

[puternut]

Big problems with me following a fall at home and a resulting haematoma (sp). It is possible I have a thrombosis/DVT on calf muscle. If it is found I have 'failed' D-Dimer blood test then I will need daily blood thinning injections and also an ultrasound is it done in the home or do I need to visit hospital?

Any advice welcome

[Sqad]

Wow! steady on!

Where was the haematoma?...In the leg? in which case that it is unlikely that you have a DVT and more likely that you have a blood clot in the muscle ....not in the vein.

If, if, the D-Dimer test indicates the presence of a DVT....then yes, you will need blood thinning therapy.

As far as i know, ultrasound is a hospital investigation........but things may have changed.

[Buenchico]

From the NHS website:
"Most ultrasound scans last between 15 and 45 minutes. They usually take place in a hospital radiology department and are performed either by a radiologist or a sonographer.

They can also be carried out in community locations such as GP practices and may be performed by other healthcare professionals, such as midwives or physiotherapists who have been specially trained in ultrasound"

http://www.nhs.uk/Conditions/ultrasound-scan/Pages/Introduction.aspx

So it's likely that an ultrasound scan would be carried out in a hospital but, given that it would almost certainly be an external scan, it would be nothing more than the quick and simple type of test that pregnant women undergo.

[Peter Pedant]

No I think this one ( U/S) is in hospital - the quality would be better for a start

Sqad- our local paed has a portable ultrasound ( but doesnt do house calls and puter nut aint a kid )

and here we have some of Sqad's anaesthetist colleagues telling everyone to use for local blocks of nerves
http://bja.oxfordjournals.org/content/94/1/7.full

( few nice piccies )

O and puternut if you ARE to be anti-coagulated try to get put on one of the new ones like rivaroxaban

[puternut]

Sorry Sqad - I always was impatient :)

2 weeks ago I had a fall indoors and within a few minutes a large haematoma appeared just below my right knee but more on the side than central. Called GP in next day and he was of the opinion that it was best to leave it as was, up painkiller and only let him know if it moved or became more painful.

1 week ago I asked him to call again as I was having pain in the lower calf/ankle and also my ankle appeared larger. The haematoma remained the same size [4"x3"]. I have suffered odema of the ankles for years. His answer was to send me to local hospital for X-ray to see if we could see what was going on. He also said in view of my mobility he would arrange a non-urgent ambo to take me.

Ambo arrived and took me into A&E where the dr decided I didnt need an X-ray (??) just have the haematoma lanced!! He couldnt clear with a needle so had to use a scalpel and then preoceeded to massage the 'gunk' out. Packed the hole with iodine soaked gauze, bandaged up - sent home with antibiotics.

District Nurses are now coming in daily to redress the wound however today I mentioned that I was having trouble actualy putting my leg onto apouffe as there was a pain in the back of the calf area. Panic stations. It might be the dreaded DVT so, got a blood sample taken this morning too (D-Dimer) and GP called to say she wouldnt do anything until the bloods result was through. Possible treatment includes daily blood thinning injections and ultrasound as I said earlier. She did prescribe more antibiotics.

As of yet, despite assurances I would know 'later today', I havent had the result.

Sorry for the length of this epistle but I do enjoy a good type

[Sqad]

LOL...well, I understand your concern.

From what you have described, a feel that a DVT is unlikely, but not impossible, the most likely scenario is a blood clot (haematoma)in the calf muscle that has become infected,

It is a good idea of your GP to exclude a DVT by the blood test..

[puternut]

D-Dimer test was negative so the threat of DVT or thrombosis has been lifted - yipee.

Still leaves a 2.5cm long by 1.5cm deep hole in my leg to heal so the true lesser of two evils.

Thanks for all the comments and advice