Effort Thrombosis in 2 Athletes Suspected of Musculoskeletal Injury.
Effort-induced upper extremity deep vein thrombosis
Paget-Schroetter syndrome
Upper extremity deep vein thrombosis, primary
Venous thoracic outlet syndrome
Journal
Journal of chiropractic medicine
ISSN: 1556-3707
Titre abrégé: J Chiropr Med
Pays: United States
ID NLM: 101163637
Informations de publication
Date de publication:
Sep 2019
Sep 2019
Historique:
received:
21
08
2018
revised:
22
11
2018
accepted:
16
01
2019
entrez:
3
9
2020
pubmed:
3
9
2020
medline:
3
9
2020
Statut:
ppublish
Résumé
This case series describes the clinical presentation of effort thrombosis and the utility of sonography in its diagnosis. Two young male athletes presented to separate chiropractic clinics with suspected musculoskeletal shoulder injury. The first complained of dull shoulder pain after pitching in a baseball game and had no other signs or symptoms. The second presented after performing a weighted plank exercise and had prominent edema and discoloration of the affected extremity. In the first patient, who had no physical signs to suggest thrombosis, a normal sonographic musculoskeletal shoulder exam prompted imaging in the abduction-external rotation position. This provided visualization of a thrombus in the axillosubclavian vein. Emergent referral followed, and treatment was initiated with thrombolysis and surgery, which resolved his condition. The second patient had physical signs consistent with effort thrombosis and was also referred to the emergency department, where sonography was performed and revealed thrombosis of the axillary and basilic veins. He responded to anticoagulants and thrombolysis and avoided surgery. Effort thrombosis has a variable presentation that can mimic common musculoskeletal disorders and has a poorly defined diagnostic pathway. Acute shoulder pain in an athlete, especially with extremity edema after repetitive exertion, warrants urgent imaging such as sonography and emergent referral. Clinicians should understand the importance of a timely evaluation and diagnosis of effort thrombosis and that imaging may include sonography as a first-line imaging tool.
Identifiants
pubmed: 32874161
doi: 10.1016/j.jcm.2019.01.004
pii: S1556-3707(20)30047-X
pmc: PMC7452328
doi:
Types de publication
Case Reports
Langues
eng
Pagination
213-218Informations de copyright
© 2020 by National University of Health Sciences.
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