A case of Paget-Schroetter syndrome (PSS) in a young judo tutor: a case report

Abstract

BackgroundWe present a case of unsuspected Paget-Schroetter syndrome (also called effort thrombosis), one of the rare causes of upper extremity deep vein thrombosis. To the best of our knowledge, this was the first such case in our hospital. Our patient may have been discharged with an incomplete diagnosis and inappropriate management but for one of the few physicians who knew about effort thrombosis, made the diagnosis, and referred the patient promptly to the appropriate team.Case presentationA 37-year-old Caucasian man who was an active judo tutor presented to the acute medical unit in our hospital. He had initially presented to his primary care physician complaining of redness and swelling of his right arm and elbow of 1 week’s duration. He had been prescribed some antibiotics by his general practitioner, but his symptoms worsened. At that point, he was referred to our hospital for further review of his arm swelling.ConclusionsWhen considering a diagnosis of deep vein thrombosis, the age, hobbies, and occupation, among other things, of individual patients should be put into context at all times to avoid missing rare causes such as Paget-Schroetter syndrome. This report is intended to raise awareness of this rare condition. Knowledge of this condition and its management is essential for all medical practitioners, especially medical doctors who are involved in unselected medical admissions in accident and emergency or medical admission units, where the majority of such patients are seen.

Paget-von Schroetter syndrome: Case report

“…It occurs mostly in young people, with an average age of 30 years, healthy and athletic, with a higher incidence in men and, in 80% of cases, the dominant arm is affected. The outstanding feature is a lifestyle that involves repetitive and vigorous movements of the upper limbs [3] , [7] , [8] , [9] , mainly abduction, external rotation and hyperextension of the shoulder and neck [4] . In the report presented, the patient is male, 24 years old, and performed such movements, in addition to lifting weights, adding more strength to the exercise, increasing the risk [4] .…”

“…Paget-von Schroetter syndrome may be asymptomatic, but common features include hyperemia, edema, heaviness and pain in the affected arm, usually 24 h after the initial event and may be accompanied by low-grade fever [8] . As a differential diagnosis one can consider cellulitis, lymphedema, muscle trauma, neoplastic venous compression and superficial venous thrombosis.…”

“…Doppler ultrasound is reliable and is generally 78% to 100% sensitive and 82% to 100% specific in detecting the syndrome [11] , [12] . In patients with negative Doppler, but with a high index of suspicion, computed tomography and angioresonance are useful for the diagnosis [4] , [8] . Doppler ultrasonography is reliable and is generally 78% to 100% sensitive and 82% to 100% specific in detecting the syndrome [11] , [12] .…”

Imaging of venous compression syndromes

“…All rights reserved. Cardiovasc Diagn Ther 2016;6(6):519-532 cdt.amegroups.com throwing, rowing, rock-climbing, judo, and cheerleading (39,(44)(45)(46)(47). Similarly, the syndrome has been reported in a variety of professions involving heavy upper extremity use ranging from soldiers to television cameramen to kebab chefs (1,(48)(49)(50).…”

Recurrent pulmonary embolism related with Paget–Schroetter syndrome: a case report

“…Upper extremity deep vein thrombosis (UEDVT) is known as a rare diagnosis and currently accounts for ∼10% of all deep vein thrombosis (DVT) cases 1 . Paget–Schroetter Syndrome (PSS), also known as effort thrombosis, is an unusual, cause of UEDVT and has remained frequently undiagnosed or misdiagnosed.…”