If phlebitis is suspected or diagnosed, it is essential to have a venous duplex ultrasound scan performed by a specialist who scans veins every working day.
Not only does the venous duplex ultrasound scan confirm the diagnosis of phlebitis, it also shows the extent of the phlebitis and allows for an accurate treatment plans to be identified.
Not having a venous duplex ultrasound scan can make diagnosis difficult and many people who are diagnosed clinically as having phlebitis actually have other conditions such as cellulitis, venous eczema or lipodermatoscleosis. The treatment for all of these other conditions is different and missing the need for anticoagulation medication such as Warfarin can be very dangerous.
Even if the venous duplex ultrasound scan confirms the diagnosis of phlebitis, the correct treatment depends on how extensive the phlebitis is, and whether it is extending towards, or even into, the deep vein.
Finally without a venous duplex ultrasound scan, the underlying cause of the phlebitis (usually varicose veins or hidden varicose veins) won’t be found and so the appropriate preventative treatment to stop it coming back again won’t be identified.
In most people, phlebitis is a relatively minor condition that needs a venous duplex ultrasound scan to confirm diagnosis and then aspirin and support stockings in the short term, with varicose vein surgery planned for the future to prevent recurrence.
However in some cases, the venous duplex ultrasound scan shows extension of the clot to within 5cm of the deep system, or even into the deep system, becoming a Deep Vein Thrombosis (DVT) which might potentially move to the lungs (known as a pulmonary embolism or PE).
This is a potentially serious, or even lethal condition which needs to be treated urgently with anticoagulation such as Warfarin.
Any delay in getting a specialised venous duplex ultrasound scan after a diagnosis of suspected Phlebitis can be detrimental to a patient’s health.