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The purposes of this pictorial essay are as follows: (1) Review a systematic approach to using sonography in the initial evaluation of patients with acute arm swelling and permanent dialysis access. (2) Identify normal grayscale and Doppler findings in arteriovenous fistulas and grafts. (3) Discuss a spectrum of vascular differential diagnoses for arm swelling in this setting, including stenosis of the access, draining vein complications, thrombosis, steal syndrome, and aneurysms, as well as several nonvascular causes. (4) Recognize findings that warrant further imaging evaluation or intervention.


Reddy, S.N., Boros, M.C. and Horrow, M.M. (2015) Approach to the Swollen Arm With Chronic Dialysis Access: It’s Not Just Deep Vein Thrombosis. Journal of Ultrasound in Medicine . August 25th. .

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