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The Negative Radionuclide Venogram: An Indication for Conservative Therapy?

A retrospective study of 51 patients with a negative lower extremity radionuclide venogram and a 6-month followup was performed. None of the patients received anticoagulation. Fifty of the 51 patients had no subsequent symptoms nor signs suggesting undiagnosed deep venous thrombosis or pulmonary emboli. On reviewing the radionuclide venogram of the one patient who returned with persistent symptoms and signs of deep venous thrombosis, it was found that the initial radionuclide venogram was misinterpreted. These findings suggest that a negative radionuclide venogram, properly performed and interpreted, implies the absence of clinically significant deep venous thrombosis.