Prospective study of thrombophlebitis and "pseudothrombophlebitis"

Area of Science:

• Vascular Surgery
• Diagnostic Imaging
• Musculoskeletal Radiology

Background:

• Calf pain is a common symptom, often leading to clinical suspicion of deep venous thrombosis (DVT).
• Popliteal cysts are frequently encountered but their role in calf pain and differential diagnosis of DVT requires clarification.

Purpose of the Study:

• To evaluate the diagnostic utility of arthrography, venography, and ultrasound in patients with suspected DVT.
• To determine the prevalence and clinical significance of popliteal cysts in patients presenting with calf pain.

Main Methods:

• Retrospective analysis of 43 non-surgical patients with clinical diagnosis of DVT.
• Utilized arthrography, venography, and ultrasound for patient evaluation.
• Correlated imaging findings with clinical presentation and symptoms.

Main Results:

• Only 14 out of 43 patients had venographic evidence of DVT.
• Popliteal cysts were identified in 16 patients; 9 were considered the likely cause of symptoms despite normal venograms.
• Ultrasound detected only 2 of the 16 popliteal cysts, highlighting its limitations in visualizing these structures.

Conclusions:

• Popliteal cysts are an important consideration in the differential diagnosis of calf pain, potentially mimicking DVT.
• The presence of a Baker's cyst should not preclude venography in suspected DVT cases.
• Clinical signs alone are insufficient for differentiating DVT from popliteal cyst-related symptoms.