Definition
A phlebitis of the leg is an inflammation limited to a certain section of the vein. The wall of the venous blood vessel is usually the point of attack for the human immune system that causes the inflammation. A distinction is made between inflammation of the superficial leg veins and inflammation of the deeper veins. The inflammation can be clearly pronounced as an acute event, as in thrombophlebitis, an inflammation of the superficial veins, or it can be subliminal, as in chronic venous insufficiency.
The causes
The causes of an inflammation of the venous vessels of the legs are different and broadly diversified and can therefore be treated by different medical disciplines. The most common cause is probably thrombotic phlebitis. Usually a combination of little fluid, long periods of sitting, increased age and a family predisposition leads to the development of thrombosis.
This then closes the vein, prevents the blood flow and causes the immune system to react by causing an inflammation at the obstructed site. In chronic venous insufficiency, fluid and small proteins are released from the blood around the smallest venous blood vessels into the surrounding tissue. Here, too, the immune system recognizes an error and starts a slight inflammation around the “leaking” smallest blood vessels.
This inflammation, however, is far less present and painful, but rather takes place in secret. A third major cause is various autoimmune diseases that are directed against the patient’s own blood vessels, so-called vasculitis. These mainly affect components of the blood vessel walls that are recognized as foreign by the immune system. Depending on the disease, not only veins but also arteries are affected
The diagnosis
The diagnosis of an inflammation of the veins, a so-called phlebitis, is made by the doctor from a combination of anamnesis (recording of the history of the disease), physical examination, imaging and a blood count. In the case of thrombosis of the leg veins – which is the most common cause – the medical history and physical examination show a fairly clear picture, which is validated by ultrasound and various laboratory parameters from the blood test. The other causes mentioned usually give more unspecific anamnesis, so that a larger blood count often provides certainty in the case of justified suspicion of an autoimmune disease. Chronic venous insufficiency, on the other hand, is usually associated with leg edema and superficial varicose veins and can also be validated with the aid of an ultrasound device.
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