Homans' symptom is one of the leading symptoms for detecting 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 rather urgent problem; according to statistics, 1/5 of the population suffers from the disease. 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, reddening of the skin, and fever. On palpation, the doctor detects compacted nodules at the sites of attachment of the thrombus. Most often, the diagnosis is not difficult.
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. With chronicIn the process, venous valves are destroyed, skin pigmentation appears, and trophic ulcers may occur. Deep thrombosis can be suspected 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;
- shin swelling;
- hardening of the subcutaneous tissue.
On examination, Homans' symptom is positive - 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 was 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 knee joint at a right angle. With the back movement of the foot (towards oneself), soreness in the hind muscles of the legs increases sharply. According to the author himself, the positive symptom of Homans is due to compression of the affected deep veins by the muscles.
Measurement of the circumference of the right and left lower leg helps the diagnosis, respectively, the affected limb will have a larger diameter.
The symptom of Homans 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 surface of the lower leg are revealed. The local temperature is rising.
Instrumentaldiagnostic methods: vascular ultrasound, duplex scanning, rheovasography.
Differential diagnosis
Symptoms similar to thrombophlebitis can occur with other diseases of the legs. Puffiness of the lower extremities is observed with lymphostasis, circulatory failure, traumatic injury, arthrosis of the knee joints. In these cases, Homans' symptom is negative.
Sometimes soreness and swelling occur even after a minor injury, especially in old age. As soon as a person makes an awkward movement, jump or run, a hematoma appears between the muscles. After a few days, it descends to the ankles, the leg becomes bluish in this place.
Since there are a large number of diseases accompanied by swelling and pain in the legs, do not neglect the advice of a surgeon. It is he who will find out the cause of the pathology.
