When is duplex ultrasonography indicated for the evaluation and management of superficial thrombophlebitis?

Updated: Apr 17, 2019
  • Author: Khanjan H Nagarsheth, MD, MBA; Chief Editor: Vincent Lopez Rowe, MD  more...
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Answer

All patients with superficial thrombophlebitis above the knee should undergo duplex US as the initial diagnostic modality of choice to rule out DVT. When the patient has superficial thrombophlebitis below the knee, duplex US is only indicated for signs and symptoms consistent with DVT (eg, asymmetrical swelling, erythema, pain). Superficial thrombophlebitis in lower-extremity varicose veins has an extremely low incidence of DVT. [21]

After an initial diagnosis of superficial thrombophlebitis, especially in the thigh region, a follow-up duplex US examination in 48-72 hours should be performed to look for progression of disease after treatment is initiated. A finding of no clot extension indicates successful therapy. Thrombus extension or encroachment toward the deep venous system should prompt more aggressive treatment.


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