Gray scale and color duplex ultrasound showing reflex with the valsalva maneuver at the saphenofemoral junction (SFJ). Note the valve leaflets on the left image never oppose one another.
Iliac vein compression may cause pelvic venous congestion.
Nutcracker syndrome is one of the causes of secondary pelvic congestion syndrome.
62 year old female with 2 months of short distance claudication and rest pain at night