Ginsberg et al reported criteria for the diagnosis of the postthrombotic syndrome (PTS) in patients undergoing hip or knee arthroplasty. The authors are from McMaster University and the Academic Medical Centre in Amsterdam.

Criteria - all of the following:

(1) history of a deep vein thrombosis >= 6 months prior to onset of symptoms

(2) typical pain and swelling - both of the following for >= 1 month (chronic):

(2a) worse after standing and vertical activity

(2b) relieved by rest and the horizontal position

(3) evidence of venous valvular incompetence by plethysmography (photo, venous, air), with early venous refilling (reflux)


Swelling tends to be progressive. It is better when waking up and worse when going to bed.


Veins tested:

(1) common femoral

(2) superfical femoral

(3) popliteal

(4) posterior tibial

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