What is the cause of a palpable cord in the leg, also known as a palpable cord (thrombophlebitis) or deep vein thrombosis (DVT)?

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Last updated: April 29, 2025View editorial policy

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Differential Diagnosis for Palpable Cord Leg

  • Single most likely diagnosis
    • Deep Vein Thrombosis (DVT): This is the most likely diagnosis due to the presentation of a palpable cord in the leg, which is a classic sign of DVT. The cord-like structure felt is often a thrombosed vein.
  • Other Likely diagnoses
    • Varicose veins: These can sometimes feel like cords under the skin, especially if they are large and tortuous.
    • Superficial thrombophlebitis: Inflammation of a superficial vein can cause it to feel like a cord.
    • Lymphedema: While not typically described as a cord, in some cases, the swelling and fibrosis associated with lymphedema can cause the skin and underlying tissues to feel firm and cord-like.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Popliteal artery aneurysm: Although less common, a palpable mass in the popliteal fossa could be an aneurysm, which is a serious condition requiring prompt intervention.
    • Malignancy (e.g., soft tissue sarcoma): Rarely, a palpable cord could be a sign of a malignant process, such as a soft tissue sarcoma.
  • Rare diagnoses
    • Thrombophlebitis of a superficial vein with significant inflammation and scarring, leading to a cord-like feeling.
    • Chronic venous insufficiency with significant fibrosis and scarring, potentially feeling like a cord.
    • A congenital or acquired vascular malformation that presents as a palpable cord.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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