A Case Report on Paget-Schroetter Syndrome Presenting as Acute Localized Rhabdomyolysis

Abstract

Introduction: The life- or limb-threatening differential diagnosis for upper extremity swelling can include deep vein thrombosis (DVT), infectious processes, and compartment syndrome. Chronic anatomic abnormalities such as axillary vein stenosis are rarely a consideration in the emergency department. Case Report: We present a 26-year-old female with history of Chiari type 1 malformation who presented with acute left arm swelling. Initial workup, including point-of-care ultrasound, revealed the presence of significant soft tissue swelling without evidence of DVT. Conclusion: Further workup revealed an early, localized rhabdomyolysis secondary to axillary vein stenosis or venous thoracic outlet syndrome, also known as Paget-Schroetter syndrome.

Upper Extremity Deep Venous Thrombosis: Etiologies, Diagnosis, and Updates in Therapeutic Strategies

“…11 Phlegmasia cerulea dolens and rhabdomyolysis occur rarely. 12 Collateral veins over the chest (Urschel's sign) can develop in those with underlying chronic central venous stenosis (as with VTOS or implantable devices). A palpable venous cord can be apparent with superficial thrombophlebitis.…”