Superficial thrombophlebitis

Background

Superficial thrombophlebitis is also known as "superficial venous thrombosis" and mainly involves symptomatic control. It is more likely in patients with varicose veins Associated DVT usually only occurs at the junctions with deep venous system such as the groin

The disease is categorized into 4 main types:

1. Sterile thrombophlebitis
   • No infectious association
2. Traumatic superficial thrombophlebitis
   • Associated with limb injury from blunt trauma, IV catheters or chemical treatment
3. Infection thrombophlebitis
   • Associated with prolonged IVs and is the only thrombophlebitis to require antibiotics
4. Migratory thrombophlebitis
   • Recurrent in multiple differing sites and often associated with malignancies

Differential Diagnosis

The differential depends on the location of the thrombophlebitis.

Calf pain

• Achilles tendon rupture
• Calcaneal bursitis
• Cellulitis
• Compartment syndrome
• Deep venous thrombosis (DVT)
• Distal leg fractures
• Gastrocnemius strain
• Ruptured popliteal cyst (Bakers cyst)
• Superficial thrombophlebitis

Upper extremity swelling

• Cellulitis
• Deep venous thrombosis
  • Paget-Schroetter syndrome
• Lymphatic obstruction
• Necrotizing fasciitis
• Superficial thrombophlebitis
• SVC Syndrome
• Thoracic outlet obstruction/Pancoast tumor

Groin pain

• Athletic pubalgia
• Cellulitis
• Deep venous thrombosis
• Hernia
• Superficial thrombophlebitis

Diagnosis

The diagnosis is purely clinical. D-dimer has no clinical benefit and only consider DVT evaluation if there is significant limb swelling or location at a deep vein (popliteal/femoral vein)

Signs and Symptoms

• Pain and discoloration to affected area
• Redness affected superficial vein
• Tender and hard vein on palpation
• Minimal limb swelling

Management

• NSAIDS for local pain
• Antibiotics are only needed if there is an associated cellulitis or obvious infection

See Also

• DVT
• Cellulitis