Dolens

Dolens is a historical medical term derived from the Latin dolens, meaning painful or suffering. In medical usage, it is most closely associated with phlegmasia dolens, a description of a painful, swollen leg caused by venous thrombosis, particularly deep vein thrombosis (DVT). The term phlegmasia dolens has been used to describe severe DVT with marked edema and pain, and it is contrasted with phlegmasia alba dolens (white leg) and phlegmasia cerulea dolens (blue leg), which denote varying degrees of venous outflow obstruction and tissue ischemia.

Historically, dolens also referred to postpartum leg swelling known as the "milk leg," a condition linked to venous thrombosis after childbirth. Today, these terms are largely of historical or descriptive value, and contemporary practice uses precise terminology such as DVT and phlegmasia dolens to guide diagnosis and treatment.

Causes and risk factors align with Virchow's triad: venous stasis, hypercoagulability, and vascular injury. Risk factors include recent surgery, prolonged immobility, cancer, pregnancy or postpartum state, hormonal therapy, and inherited thrombophilias. Clinically, dolens-like presentations involve unilateral leg swelling, warmth, tenderness, and aching; progression can lead to color changes and reduced leg function in severe cases.

Diagnosis typically relies on duplex ultrasonography to detect venous thrombosis, with D-dimer testing as an adjunct in selected patients. Treatment centers on anticoagulation to prevent thrombus propagation, with escalation to thrombolysis or surgical thrombectomy in life- or limb-threatening situations. Prevention emphasizes risk-factor modification and appropriate prophylaxis in high-risk individuals.