All veins should be easily collapsible under direct pressure from the ultrasound transducer. Here the lack of collapse of the internal jugular coupled with an obvious hyperechoic mass suggests a thrombus in this vein making cannulation ill-advised.
this is a scan of presumably the right internal jugular vein i'm judging by the thyroid gland here with the right internal jugular vein in the right carotid artery i'm using a linear transducer on a vascular preset and as we scan through the ij vein we notice there is obviously a hyperechoic non-compressible structure here in the middle of the vein suggesting an internal jugular thrombus you
