Sievering Clinic

Competence Centre for Minimally Invasive Medical Services

Phlebitis

Symptoms

The area around the vein is red, swollen, and often painful. Because the blood in the vein tends to clot, the vein feels hard, not soft like a normal vein. The vein can feel hard down its entire length.

Superficial phlebitis
There is usually a slow onset of a painful tender red area along a superficial vein under the skin. A long, thin red area may be seen as the inflammation follows a superficial vein.
This area may feel hard, warm, and tender. The skin around the vein may be itchy and swollen.
Symptoms may be worse when the leg is lowered, especially when first getting out of bed in the morning.
Sometimes phlebitis may occur where a peripheral intravenous line was started. The surrounding area is swollen and may be sore and tender along the vein.
If an infection is present, symptoms may include redness, fever, pain, swelling, or breakdown of the skin.
Deep vein thrombophlebitis
This can be similar in presentation to superficial phlebitis, but some people may have no symptoms.
One may have pain and swelling throughout the entire limb. For example, one side of the lower leg may swell for no apparent reason.
Some people also get fever from a superimposed bacterial infection and skin discoloration and/or ulcers if the condition becomes chronic and inadequately treated earlier.
When to Seek Medical Care
Call your health care provider if you have signs and symptoms of swelling, pain, and inflamed superficial veins on the arms or legs. If you are not better in a week or two, get re-evaluated to make sure you don’t have a more serious condition.

Deep vein thrombophlebitis requires immediate medical care.

If you have any of these signs and symptoms, go to a hospital emergency department for evaluation:

  • High fever with any symptoms in an arm or leg
  • Lumps in a leg
  • Severe pain and swelling in an arm or leg
  • New, unexplained significant shortness of breath, which could be the first tip-off that a blood clot has already travelled to your lung

Diagnosis

Your health care provider can tell that someone has phlebitis by examining the veins. An ultrasound scan may be performed to see if the phlebitis has spread into a deep vein. Ultrasound can detect clots or blockage of blood flow, especially in larger, more proximal (upper leg) veins. A small hand-held instrument (probe) is pressed against your skin to help identify blood clots and where the obstruction is. This is a painless, non-invasive test.

Occasionally a venogram is needed to identify blood clots in the smaller, more distal veins. This is an invasive procedure that requires injecting x-ray dye or contrast material into a vein on the foot, and then an x-ray is taken of the flow of the dye up the leg.