Pseudothrombophlebitis
From Wikipedia, the free encyclopedia
| Pseudothrombophlebitis | |
|---|---|
| Specialty | Phlebology |
Pseudothrombophlebitis is a clinical condition where there are signs and symptoms of phlebitis in the absence of a thrombophlebitis lesion. Symptoms include pain, swelling, erythema and tenderness evolving over hours or days. It is often associated with the rupture or dissection of a popliteal cyst otherwise known as a Baker's cyst,[1] although it can be associated with other disorders such as the arthritides. It may also occur as an orthopaedic surgical complication, secondary to trauma or as a presentation of septic arthritis. It is crucial to differentiate this condition from deep vein thrombosis as the treatment for DVT can cause adverse effects in patients with pseudothrombophlebitis.
The symptoms of pseudothrombophlebitis include pain, swelling, erythema and tenderness. It most commonly, but not exclusively, affects the legs. The presence of a popliteal cyst makes this diagnosis more likely. However, the presence of a popliteal cyst does not rule out deep vein thrombosis and warrants further investigation. Pseudothrombophlebitis and deep vein thrombosis are not mutually exclusive conditions, and in rare instances may co-occur.[2]
Pseudothrombophlebitis is clinically indistinguishable from a true thrombophlebitis such as deep vein thrombosis; the symptoms and history are similar and these conditions cannot be distinguished by clinical examination without radiological or arthroscopic imaging.[citation needed]
It is crucial however to differentiate pseudothrombophlebitis from DVT as the thrombolytic and anticoagulant treatments usually administered in DVT are not effective in treating pseudothrombophlebitis, and may have adverse effects exacerbating the condition.[3]
Pathophysiology
Commonly, pseudothrombophlebitis is caused by rupture of a popliteal cyst causing leakage of synovial fluid, leading to inflammatory irritation to the gastrocnemius muscle.[citation needed]
Pseudothrombophlebitis is not the only possible consequence of a popliteal cyst. The existence of a large popliteal cyst can be a risk factor for deep vein thrombosis. Furthermore, a ruptured popliteal cyst may cause compartment syndrome in the calf or even the thigh.[citation needed]