Diagnosis of Varicose Veins


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The diagnosis of varicose veins involves two things, the first is to confirm that you have varicose veins, and the second is to determine whether or not your require treatment for them.

When to See a Doctor about Varicose Veins

It is possible that your varicose veins will not cause you any discomfort, pain, or complications and as a result of this you will not require medical treatment or diagnosis. However, if you are concerned about your varicose veins, uncertain about whether you have varicose veins or a different condition, or if they are causing you any complications you should speak to a doctor. Factors, which should lead you to see your doctor include:

  • Pain or discomfort on or around your varicose veins
  • Sore, irritated or discoloured skin on or around your varicose veins
  • Achy or swollen legs, which cause you discomfort particularly at night
  • Any circulatory illness e.g. high blood pressure
  • A previous deep vein thrombosis
  • If you are on medication and are worried that this has caused or worsened your varicose veins

How Your Varicose Veins are Assessed

Initially your doctor will diagnose your varicose veins based on what they look like; they will do this whilst you are standing, as your varicose veins will be more prominent in this position. After they have checked for swelling, you will be asked what kind of pain or discomfort you suffer, if any, and when this normally occurs or worsens. The doctor will also examine you for any risk factors such as:

  • Being pregnant
  • Being overweight
  • Having a deep vein thrombosis
  • Having a previous leg injury

It may not be clear what is the cause of your varicose veins, in this case you will be sent to a vascular specialist to rule out any underlying conditions. The vascular specialist will examine your varicose in the same way as your GP and may also listen to your blood flow using a stethoscope. Vascular specialists usually use one of two tests to thoroughly examine your legs. The purpose of this examination will be to rule out the possibility of further varicose veins and to find out if any other condition is causing your varicose veins.

Tests to Examine Varicose Veins

Both of the tests used to examine varicose veins use an ultrasound scan to check for blood flow, obstructions, and valve functioning. An ultrasound works by sending high frequency sound waves through your skin, when these hit an object, for example the veins, they are reflected back as an echo. This echo is converted into an accurate image of your veins and the flow of blood through them. The point of both tests is to determine whether you have venous reflux, which is a term to describe the backflow of blood that causes varicose veins.

One of the ways that ultrasound is used is through the Doppler test which gives a clear image of blood flow. Using this image a specialist, can pin- point any malfunctions in the valves or walls of the veins, and determine if there are any obstructions or problems, which are causing the abnormalities.

Another way of testing the functioning of your veins is using a colour duplex ultrasound. This uses similar technology but provides the specialist with a colour image, which can be used to work out the speed of your blood flow and check for any problems in the walls or valves of the veins.

If ultrasound testing does not show that venous reflux is the cause of your varicose veins you will need further testing using an MRI scan. This should show up any abnormalities within your entire body enabling the doctors to find the cause of your varicose veins.


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