Superficial Thrombophlebitis Differential Diagnoses

Updated: Mar 22, 2023
  • Author: Khanjan H Nagarsheth, MD, MBA; Chief Editor: Vincent Lopez Rowe, MD, FACS  more...
  • Print

Diagnostic Considerations

Conditions to consider in the differential diagnosis of superficial thrombophlebitis include the following:

  • Cellulitis
  • Deep venous thrombosis (DVT)
  • Lymphangitis
  • Neuritis
  • Ruptured medial head of the gastrocnemius
  • Tendonitis
  • Baker cyst
  • Chronic venous insufficiency
  • Hematoma
  • Lipodermatosclerosis
  • Lymphedema
  • Postphlebitic syndrome
  • Septic thrombophlebitis
  • Varicosities

Patients who lack deep system involvement may rarely progress to develop DVT over time. Also, patients who present with clinical evidence of superficial phlebitis may rarely have deep system involvement that is clinically occult. The incidence of fatal pulmonary embolism (PE) in these patients is not insignificant. Any chest symptoms, no matter how minor, should be considered extremely worrisome in a patient with superficial thrombophlebitis, as PE is not uncommon and can be difficult to diagnose.

Phlebitis that has progressed to involve any other deep veins (anterior or posterior tibial veins, proximal peroneal vein, popliteal vein, or femoral vein at any level) is a life-threatening condition that must not be confused with superficial venous thrombophlebitis.

The principal deep vein of the thigh, the femoral vein, often is referred to incorrectly as the "superficial femoral vein." Do not be misled by this nomenclature. A thrombus in this vein is the most serious type of DVT.

Differential Diagnoses