Symptom of Homans - one of the leading symptoms for the detection of thrombophlebitis of deep vessels of the lower extremities. It helps to make a diagnosis in the first 2-4 days from the start of the process. Thrombophlebitis is a fairly urgent problem, according to statistics, 1/5 of the population suffers from an ailment. It is characterized by inflammation of the veins (phlebitis), impaired blood flow and the formation of blood clots inside the vascular bed.
Superficial and deep thrombophlebitis
Superficial thrombophlebitis often occurs in the area of varicose veins and can be detected visually. With superficial inflammation, the vessels located between the skin and muscles suffer. There is acute pain along the damaged vein, redness of the skin, and temperature rises. On palpation, the doctor discovers compacted nodules at the sites of attachment of the thrombus. Most often, the diagnosis is straightforward.
Another situation occurs with deep thrombophlebitis, because the veins located inside the muscles are invisible. Approximately 50% of patients do not even realize that they have thrombophlebitis. In a chronic process, venous valves are destroyed , skin pigmentation appears, trophic ulcers can occur. You can suspect deep thrombosis by the following signs:
- drawing pains in the muscles of the lower leg, aggravated by prolonged standing or when lowering the leg down;
- feeling of fullness in the legs;
- swelling of the leg;
- compaction of subcutaneous tissue.
On examination, a positive Homans symptom appears - this is the most characteristic sign of inflammation and deep vein thrombosis. It allows you to make a preliminary diagnosis already during the initial examination.
How to diagnose deep thrombophlebitis?
The Homans symptom is described by the American doctor J. Homans in 1934. To determine deep thrombophlebitis, the patient is laid on his back, while the leg is asked to bend at the right angle in the knee joint. With the back movement of the foot (towards yourself), pain in the hind muscles of the legs increases sharply. According to the author himself, a positive symptom of Homans is caused by squeezing the affected deep veins with muscles.
Measuring the circumference of the right and left lower leg helps the diagnosis, respectively, the affected limb will have a larger diameter.
Homans symptom is not the only sign of the disease. On examination, increased skin sensitivity, pain when pressing on the lower leg in the anteroposterior direction (Moses symptom), local pain when feeling the inner and back surfaces of the lower leg are revealed. The local temperature rises.
Instrumental diagnostic methods: ultrasound examination of blood vessels, duplex scanning, rheovasography.
Differential diagnosis
Symptoms similar to thrombophlebitis can occur with other diseases of the legs. Swelling of the lower extremities is observed with lymphostasis, circulatory failure, traumatic injury, arthrosis of the knee joints. In these cases, the Homans symptom is negative.
Sometimes soreness and swelling occur even after a minor injury, especially in old age. Once a person makes an awkward movement, jump or run, a hematoma appears between the muscles. After a few days, she lowers to the ankles, the leg in this place becomes cyanotic.
Since there are a large number of diseases accompanied by swelling and pain in the legs, do not neglect the advice of a surgeon. He will find out the cause of the pathology.