The role of duplex ultrasound in the diagnosis of pelvic venous disease

Recently there is an increased awareness of the possibility of pelvic venous disorders in patients with phlebological disease. The pathophysiology involves venous reflux or obstruction or a combination of both. It has been recommended that valvular function should be determined by the duration of reflux with the patient in an upright position. However the term ‘reflux’ is being used avidly by those assessing magnetic resonance imaging and computer tomography where patients are in a supine position. Venous compression is a common finding when the patient is supine and does not necessarily mean pathology. Duplex ultrasound is probably the only diagnostic tool which allows for examination in both supine and upright positions.