The early diagnosis of thrombosis of the deep veins of the legs is one of the most difficult, as well as most important diagnoses doctors have to make. The condition, frequently, is unsuspected until embolism occurs. This missed diagnosis may cause a serious or a fatal complication. While surgical or anticoagulant therapy, or a combination of the two, can reduce effectively these complications, the diagnosis must be made first.
In a previous report on the diagnosis and treatment of thrombosis of the deep veins of the leg, I briefly mentioned the presence of three dilated veins over the tibia as an early sign.1 Since then, this phenomenon has been observed so consistently that the term "sentinal" veins has been coined for it. I believe that these veins are the earliest objective sign of deep vein thrombosis and that attention should be directed to their presence so that effective therapy