From the Guidelines
Symptoms of a popliteal deep vein thrombosis (DVT) typically include pain, swelling, warmth, and redness in the affected leg, particularly behind the knee in the popliteal fossa, as noted in the acr appropriateness criteria for suspected lower extremity deep vein thrombosis 1.
Key Symptoms
- Pain, especially when walking or flexing the foot upward
- Swelling, warmth, and redness in the affected leg
- Calf tenderness
- Edema, with the affected leg appearing larger than the unaffected leg
- Skin feeling warm to the touch with a reddish or bluish discoloration
- Heaviness or cramping in the leg
- Visible surface veins or hardened veins that can be felt under the skin
Importance of Prompt Medical Attention
It is crucial to seek medical attention if DVT is suspected, as it can lead to serious complications like pulmonary embolism if left untreated, with a mortality rate of 25% to 30% 1.
Diagnosis and Treatment
Diagnosis typically involves ultrasound imaging of the leg veins, and treatment usually consists of anticoagulant medications to prevent clot growth and reduce the risk of embolism, as the benefits of anticoagulation therapy in patients with proximal DVT outweigh its risks 1.
From the Research
Popliteal DVT Symptoms
- The symptoms of popliteal DVT can include long-standing calf discomfort, as seen in a 28-year-old woman who presented with left leg popliteal and calf deep vein thrombosis without obvious cause 2.
- Other symptoms may include pain, swelling, erythema, and dilated veins in the affected limb, which are common symptoms and signs of DVT 3.
- In some cases, popliteal venous entrapment may present with manifestations of typical venous disease, including deep vein thrombosis and chronic venous insufficiency 2.
- The diagnosis of DVT requires a multifaceted approach that includes clinical assessment, evaluation of pre-test probability, and objective diagnostic testing, such as compression ultrasound 4, 3.
Diagnosis and Treatment
- Compression ultrasound is a reliable method for diagnosing proximal DVT, including popliteal DVT, and can be performed in the emergency department by emergency physicians 4.
- Anticoagulation is indicated to control symptoms, prevent progression, and reduce the risk of post-thrombotic syndrome and pulmonary embolism in patients with confirmed DVT 3.
- Direct oral anticoagulants (DOACs) are the preferred treatment for DVT because they are at least as effective, safer, and more convenient than warfarin 3.
- Invasive catheter-based therapies that remove thrombus and correct venous outflow obstructions may improve outcomes and morbidity in patients with iliofemoral DVT, which includes proximal DVT involving the popliteal vein and above 5.