[Stress phlebitis of the upper extremity. Medico-legal aspect].

Stress phlebitis of the upper extremity is in fact due to compression of the subclavian vein in the costo-clavicular space during certain movements, the effort being only a fortuitous component. Clinically, it evolves in two stages: at the stage of intermittent compression, the functional symptoms are related to certain positions of the upper extremity; the compression is identified clinically and with additional tests. Treatment includes physical therapy; however, persistence of the symptoms may result in having to consider the resection of the first rib. At the stage of organized phlebitis, the diagnosis is obvious although sometimes unrecognized, and the current consensus is to use anticoagulants: heparin followed by anti-vitamin K. From a medico-legal standpoint, stress phlebitis of the upper extremity is not considered a professional disease, but if it is possible to attribute it to a type of work requiring frequent upward positioning of the arms, there is an obligation for these patients to be rehabilitated professionally.