Last reviewed: February 2018
Last updated: November  2017



History and exam

Key diagnostic factors

  • previous superficial vein thrombophlebitis (SVT), DVT, or PE
  • redness/erythema of overlying skin
  • hot/warm overlying skin
  • painful/tender over affected vein
  • swelling/edema of surrounding area
  • cord-like mass palpable
  • development of symptoms over hours to days
  • signs/symptoms of concomitant DVT or PE

Other diagnostic factors

  • varicose veins
  • hx of thrombophilic disorders
  • autoimmune diseases (e.g., Behcet and Buerger disease)
  • recent vein instrumentation (e.g., sclerotherapy)
  • recent vein cannulation and intravenous drug administration
  • low-grade fever
  • pigmentation changes

Risk factors

  • varicose veins
  • thrombophilic disorders
  • malignancy
  • autoimmune diseases (e.g., Behcet and Buerger disease)
  • pregnancy
  • use of oral contraceptives and hormonal replacement therapy
  • prior history of SVT
  • female sex
  • older age
  • history of prior venous thromboembolism (VTE), including DVT and PE
  • obesity
  • prolonged immobilization (e.g., long-haul air travel)
  • sclerotherapy
  • intravenous catheterization

Diagnostic investigations

1st investigations to order

  • Doppler ultrasonography
Full details

Investigations to consider

  • biopsy
  • ventilation perfusion (VQ) scan
  • pulmonary CT angiography
  • conventional pulmonary angiography
  • assessment for malignancy
  • thrombophilia screening
Full details

Treatment algorithm


Authors VIEW ALL

Vicky Tagalakis

Associate Professor

Department of Medicine

McGill University




VT has received reimbursement for consultancy work for Pzifer Canada, Sanofi Canada, Bayer, Bristol Myer Squib, and Leo Pharma. She has received an investigator-initiated grant from Sanofi Canada.

Professor Vicky Tagalakis would like to gratefully acknowledge Frédérique St-Pierre, a medical student who worked with her to update this topic.


FSP declares that he has no competing interests.

Peer reviewers VIEW ALL


Division of Angiology and Hemostasis

University Hospital of Geneva




FB declares that he has no competing interests.

Professor of Medicine

Section of Hematology

Director of Hematologic Malignancies

Temple University School of Medicine




MB declares that he has no competing interests.

The Mary Weinfeld Professor of Clinical Research in Hemophilia

Mount Sinai School of Medicine

New York



LA declares that he has no competing interests.

Use of this content is subject to our disclaimer