Facilitating the Diagnostic Process of the Patients with Complaint of Acute Limb Swelling in Emergency Room; a Brief Report


Introduction: Limb swelling is among the frequent complaints of patients referring to the emergency room (ER). Objective: We decided to take a step towards facilitating the diagnostic process of patients who refer to ER with such complaint, and find out whether emergency medicine physicians (EMPs) can play an effective role in this regard. Methods: This was a diagnostic accuracy study in which all patients who referred to the ER with a complaint of unilateral leg swelling were studied. The patients underwent bedside sonography by the researchers, who were emergency medicine physicians (EMPs), and also underwent a second sonography by the in-charge radiologist using the same device and probe. The accuracy of the diagnoses made by researchers was evaluated using the radiologists’ opinion as the gold standard. Results: In this study, the data of 52 patients were analyzed. In general, the agreement rate between the EMPs and radiologists was 0.863, which indicates a proper agreement. Based on the findings, Kappa agreement for the four differential diagnoses ranged from 0.639 to 0.919 and the AUC was between 0.750 and 0.976. Conclusions: In this study, the overall agreement between the EMPs and radiologists was appropriate.

1. Kitchen L, Lawrence M, Speicher M, Frumkin K. Emergency Department Management of Suspected Calf-Vein Deep Venous Thrombosis: A Diagnostic Algorithm. West J Emerg Med. 2016 Jul;17(4):384-9.
2. Kennedy D, Setnik G, Li J. Physical examination findings in deep venous thrombosis. Emerg Med Clin North Am. 2001;19(4):869-76.
3. Abdolrazaghnejad A, Banaie M, Safdari M. Ultrasonography in emergency department; a diagnostic tool for better examination and decision-making. Adv J Emerg Med. 2018;2(1):e7.
4. Burnside PR, Brown MD, Kline JA. Systematic review of emergency physician-performed ultrasonography for lower-extremity deep vein thrombosis. Acad Emerg Med. 2008;15(6):493-8.
5. Shiver SA, Lyon M, Blaivas M, Adhikari S. Prospective comparison of emergency physician-performed venous ultrasound and CT venography for deep venous thrombosis. Am J Emerg Med. 2010;28(3):354-8.
6. Ferazee B, Snoey E. Diagnostic role of ED ultrasound in deep venous thrombosis and pulmonary embolism. Am J Emerg Med. 1999;17(3):271-8.
7. Kim D, Byyny R, Rice C, Faragher J, Nordenholz K and etc. Test Characteristics of Emergency Physician-Performed Limited Compression Ultrasound for Lower-Extremity Deep Vein Thrombosis. Emerg Med. 2016;51(6):684-90.
8. García JP, Alonso JV, García PC, Rodríguez FR, López MÁ, del Carmen Muñoz-Villanueva M. Comparison of the Accuracy of Emergency Department-Performed Point-of-Care-Ultrasound (POCUS) in the Diagnosis of Lower-Extremity Deep Vein Thrombosis. J Emerg Med. 2018;54(5):656-64.
IssueVol 5 No 2 (2021): Spring (April) QRcode
SectionBrief report
DOI 10.18502/fem.v5i2.5622
Acute Edema Emergency Room Extremities Point-of-Care Testing

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Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
Jafari Najafabadi F, Shojaee M, Mousaeinezhad N, Azadbakht O, Arhami Dolatabadi A. Facilitating the Diagnostic Process of the Patients with Complaint of Acute Limb Swelling in Emergency Room; a Brief Report. Front Emerg Med. 5(2):e22.


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