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How do you diagnose post thrombotic syndrome PTS ?
Monday, December 3, 2012



While most diseases are diagnosed by medical testing methods, post thrombotic syndrome is a bit different. Diagnosis of this syndrome usually requires clinical observation of the signs and symptoms listed previously. However, because both DVT and PTS have very similar symptoms, your doctor might choose to:


  • Wait three to six months after the diagnosis/treatment of DVT to diagnose post thrombotic syndrome


  • Confirm that the underlying cause of lower extremity swelling is indeed of venous origin


  • Use ultrasound technology to confirm the diagnosis


  • Use magnetic resonance imaging (MRI) to confirm the diagnosis


  • Compression ultrasonography testing for persistent abnormalities in patients with recurring ipsilateral DVT


  • Use the Villalta scale to classify your symptoms:          
    • This test classifies five symptoms with a severity of zero to three. The symptoms classified include: cramps, paresthesia, pain, heaviness and pruritus (itching). Six signs are also used, including: hyperpigmentation, skin induration, redness, edema, venous ectasia and pain during compression.



  • Determine a diagnosis of post thrombotic syndrome after one full month of observable pain and swelling that is made worse by walking and/or standing and relieved by rest and elevation. This diagnosis is usually made six months after DVT.

As mentioned, there is no “gold standard” by which your doctor will arrive at a diagnosis. In 99% of PTS cases, your doctor will diagnose your condition through clinical history taking and physical examination. MRI and ultrasound diagnostics can be helpful, but are sometimes not employed, particularly if your doctor is familiar with your case, you have several (or all) of the previously mentioned risk factors and it has been some time since your DVT.


Dr. Hratch Karamanoukian is a member of the American College of Phlebology AND a Diplomate of the American Board of Phlebology. He can be contacted by calling 716-839-3638 or 


 Dr. Raffy Karamanoukian is a member of the American College of Phlebology AND a Diplomate of the American Board of Phlebology. He can be contacted by calling 310-998-5535 or 


Drs. Raffy and Hratch Karamanoukian have authored 6 books about venous disease. The books are available on Amazon Kindle and Nook books for download.


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