Few people don’t know that a person’s blood flows through veins and arteries. Both of them are dispersed throughout the body, some at the very surface of the skin, others deep beneath it. It is not easy to detect problems with deep vessels, since the external signs of the disease are weak. Multiple symptoms come to the aid of physicians - Homans and Moses, Lowenberg and Louvel, Opitz and Ramenes. Each of them is a signal that something is wrong with the blood vessels. To clarify the diagnosis, there is a difficult but accurate diagnosis, however, the reason for going to the doctor, as a rule, is the very first, initial symptoms. What are they, how are they manifested and how serious? Let's get it right.
Why are blood clots dangerous?
Before we tell you what a symptom of Moses and other symptoms are, let's clarify the situation with blood clots. In fact, these are blood clots that appear in blood vessels due to disorders in the hemostatic system. They can move along the vessel or attach to its wall. At first, blood clots are usually small, but they are able to grow, because thrombotic masses accumulate on them over time.
A moment comes when the thrombus that has grown completely clogs the vessel, which, without urgent action, can lead to death. But the closure of the vessel by 70-75% is fraught with big troubles, namely a decrease in the flow of oxygen to tissues to critical levels and the accumulation of metabolic products, which leads to intoxication. When blood clots form in a living person in blood vessels, they are diagnosed with thrombosis. This disease is known to 1/5 of the world's population, and in men it is much more common than in women. Thrombosis can occur in any veins and arteries - on the hands, in the internal organs, in the brain, but is more often observed on the lower extremities. If you do not pay due attention to the disease, it gives complications that take thousands of lives every year.
Causes of blood clots in the veins of the lower extremities
Why do some people form blood clots, while others do not? There are many risk factors here, and they are all divided into three groups - congenital, acquired and mixed. The symptom of Moses is equally relevant in any risk group. Congenital factors of the occurrence of the disease are in one or another violation of hemostasis and in mutations at the genetic level.
Among the acquired can be called these:
- advanced age;
- pregnancy;
- leg injuries (e.g., fractures);
- obesity;
- leg surgery;
- the use of certain contraceptives;
- physical inactivity;
- hormonal disorders;
- benign blood tumor (polycythemia);
- malignant tumor of the pancreas;
- some medications;
- gypsum overlay;
- the presence of a catheter in the central vein;
- infections.
Thrombophlebitis
The symptom of Moses is a sign of not only thrombosis, but also thrombophlebitis - an ailment that combines the formation of a thrombus and inflammation of a vein. The causes of its occurrence are:
- thrombophilia (tendency to form blood clots);
- a number of infectious diseases;
- vein injuries;
- violation of blood flow;
- allergy;
- change in blood composition;
- overweight;
- hypertension.
Thrombophlebitis can occur acutely and chronically. It causes the greatest danger when a fragment of a blood clot comes off, with a blood stream enters the heart or pulmonary artery. The outcome depends on the size of the fragment and on the speed of action.
Signs of vein obstruction
Not only the symptom of Moses helps to suspect that thrombosis has begun in the deep veins of the legs). The disease has such signs:
swelling of the limb;
- feelings of discomfort, fullness, pain in the limb;
- high temperature (does not always occur).
If blood clots clog vessels close to the surface of the skin, the onset of the problem is accurately determined visually by the swollen veins, a characteristic mesh in the problem area, and a change in its texture and color. If blood clots clog deep vessels, the external signs are not so distinct, plus they can indicate a number of other diseases, for example, swelling of the extremities can occur with heart failure, pain is felt with injuries. Therefore, doctors, performing clinical diagnosis, take into account the specific signs of deep vein thrombosis in the calf and lower leg.
If thrombosis occurs in the veins of the upper third of the thigh, the patient may feel pain in the lower back, sacrum, and in the inguinal zone. One of the signs of pathology can be an increase in temperature. In this case, the Moses symptom and other clinical symptoms discussed in this article are absent. Sometimes the formation of blood clots in the veins of the thigh does not give symptoms at all, and the disease becomes known too late when pulmonary thromboembolism has already occurred.
Symptom of Homans and Moses
Diagnosis by Homans is considered the most characteristic and is as follows. The patient lies on a couch on his back. The head is on the same level with the body (without a pillow). The patient's legs should be slightly bent at the knees. The doctor bends the foot of his foot in the ankle joint from the back. Moreover, if there is thrombosis in the veins of the legs to the knee, the patient develops sharp pain in the calf muscles.
The symptom of Moses is another method for the clinical diagnosis of thrombosis and deep vein thrombophlebitis. It consists in the following. The doctor squeezes the shin to the patient front and back, and then from two sides. If in the first case there is a sharp pain, and in the second it is absent, there is a high probability of a blood clot in the veins.
Other symptoms of clinical diagnosis
For greater confidence in the correctness of the preliminary diagnosis, doctors use a check not only for a Moses symptom. The photo shows the preparatory process before the Lowenberg test. The doctor first palpates the problem area of ​​the limb in the patient, then puts on the cuff of the sphygmomanometer in the central tibia of the part (middle third) and pumps air to a pressure of about 150 mmHg. Pain in the calf indicates the presence of a blood clot.
To be sure, you can put the cuff on the thigh (lower third), and not on the lower leg and also pump air into it. If at the same time pain appears in the calf, this will already be a symptom of Optitz-Raminetz.
It happens that in patients pain in the calves appears when coughing or even when sneezing. This is also a sign of thrombosis, called the Louvel symptom, but of all it is the least characteristic.
Accurate diagnosis
If the patient has a suspicion of deep vein thrombosis or thrombophlebitis, but the symptoms of Homans and Moses are negative, the patient is recommended to undergo additional diagnostics. Her methods:
- Ultrasound (dopplerography, sonoelastography);
- MRI;
- blood tests (hemostasis tests).
If the patient has swelling and soreness of the lower limb, but there are no of the above symptoms, this may be a signal of another disease, for example, the effects of trauma, heart failure, arthrosoarthritis and others. An exact diagnosis is also carried out to find out a reliable cause of problems with the legs.
Treatment
It is very important to detect deep vein thrombosis in the early stages of the disease, which, of course, is helped by the simplest methods of clinical diagnosis, such as the Homans symptom and the Moses symptom. Treatment is prescribed by a doctor, guided by clinical diagnosis, as well as the results of an accurate diagnosis. If the process is not started, therapy can be limited to conservative methods:
- application of ointments (“Hepanol”, “Heparin”, “Nise” or “Indovazin”) to the problem area, which relieve soreness, relieve inflammation, and prevent blood clots;
- ingestion of anticoagulants that dissolve blood clots and cleanse the vein bed;
- physiotherapeutic procedures (UHF and magnetotherapy to relieve swelling, electrophoresis with medications for the early dissolution of blood clots);
- hirudotherapy (leeches inject a substance in the blood that prevents its coagulation and, thereby, improves blood flow);
- elastic compression (wearing special stockings and tights).
An essential condition for treatment is bed rest.
According to indications, microoperations are performed (incision of a vein under local anesthesia) on the lower extremities to remove blood clots.
If a threat of thromboembolism (blockage) of the pulmonary artery is detected, the patient is immediately treated.
Prevention
Common truth - any disease is easier to prevent than to get rid of it. To prevent the acquired risk factors for thrombosis and the symptom of Moses, Homans and others, you need to strengthen your veins. There are many ways to do this and they are effective only in combination. It:
- diet;
- hardening (contrasting baths, walking barefoot, swimming);
- reasonable physical activity;
- foot hygiene;
- Wearing compression stockings (especially during air travel);
- avoidance of hypothermia of the legs and their hyperfatigue;
- traditional medicine that helps relieve inflammation and strengthen the walls of blood vessels.