CALF PAIN IN POST-THROMBOTIC SYNDROME

The clinical features of 27 patients with post-thrombotic obstruction to the iliac veins or inferior vena cava, compared with those of 17 patients with post-thrombotic incompetence of the peripheral deep veins alone, have shown that the chief dis- tinguishing feature is calf pain on exercise, which occurs in patients with iliac venous obstruction. The pain, “ venous claudication is usually severe enough to interfere with work and leisure activities, and usually constitutes a greater disability than varices, swelling, or ulceration. The mechanism of pain production is obscure. There is no evidence that venous distension or muscle ischaemia is responsible. A patient with the “ post-phlebitic syndrome ” who can mark time briskly for five minutes is unlikely to have significant obstruction to venous return. © 1968, British Medical Journal Publishing Group. All rights reserved.