Superficial Phlebitis vs. DVT – Clinical Patient Case of the Week

Gerard Kiernan, MD, FAAFP, FHMClinical Pearls, Emergency Medicine, Family Medicine, Guideline Knowledge Check, Internal Medicine, Nurse Practitioner, Nursing RN/PN, Pediatric Emergency Medicine, Pediatric Medicine, Personal Education, Physician Assistant, Urgent Care

Superficial Phlebitis vs. DVT, Vascular Disease Case

Superficial Phlebitis vs. DVT - Clinical Patient Case of the Week

Try this free Acute Coronary Syndromes Case Q&A courtesy of Med-Challenger.

This week's clinical patient case Q&A involves a 45-year-old man with a tender, palpable vein on the medial aspect of his right thigh proximal to the knee.  The acute coronary syndromes case comes from our Internal Medicine Board Review and CME course, part of Med-Challenger's library of board exam review and CME question banks.

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Try this case and test your knowledge of superficial phlebitis and DVT.

A 45-year-old man presents to you with a tender, palpable vein on the medial aspect of his right thigh proximal to the knee. It is overlaid by erythematous skin and is also associated with edema (see Figure 1). This problem has been present for two days and has not occurred before.

Figure 1.

superficial phlebitis

He has a history of hypertension and is taking lisinopril and hydrochlorothiazide. He also takes fish oil and multivitamin supplements. He smokes 0.5 pack/day and does not drink alcohol.

Doppler ultrasonography of the lower extremities does not reveal any deep venous involvement, but it does reveal an isolated thrombus in a tributary of the great saphenous vein that enters the saphenous vein at the mid-thigh level. Neither the saphenous nor femoral vein shows thrombus.

Question:

What is the most appropriate treatment for this patient?

Answer Options:

Corticosteroids

Nonsteroidal anti-inflammatory drugs

Unfractionated heparin

Warfarin

See the Answer:

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