Plantar vein thrombosis masquerading as plantar fasciitis: A case report

Abstract

Plantar vein thrombosis is an uncommon and under-diagnosed cause of plantar foot pain characterised by the formation of a blood clot (thrombus) within one of the plantar veins. There is no current diagnostic guideline for this condition however compression ultrasound and magnetic resonance imaging appear suitable. Treatments range from rest and non-steroidal anti-inflammatory drugs to six months of anticoagulant therapy. A 51-year old female was referred reporting a two-week history of left heel pain suspicious of plantar fasciitis. Ultrasonography and Magnetic Resonance Imaging showed thickening and expansion of the lateral plantar vein. The patient's symptoms disappeared following two weeks of non-steroidal anti-inflammatory medication and compression therapy, and follow-up ultrasound six weeks later showed recanalisation of the lateral plantar vein.

Plantar vein thrombosis: 17-year longitudinal study of consecutive patients from a Swiss academic center

“…In this small cohort, therapeutic-dose direct oral anticoagulant or low-molecular-weight heparin for 3 months appeared to be effective and safe as long as anticoagulation was continued. Other reports have suggested that a management strategy not relying on anticoagulants but rather on nonsteroidal anti-inflammatory drugs alone or combined with compression stockings could be an alternative approach [ [1] , [2] , [3] , 5 ]. Our results appear to be in line with recent findings indicating that the outcome after distal DVT secondary to major risk factors, notably cancer, may be as severe as that following proximal DVT [ 14 ].…”

“…Challenges in accurately diagnosing PVT, leading to both overdiagnosis and underdiagnosis, may obscure its true prevalence and impact. Pain, swelling, and sensation of heaviness have been described as typical symptoms [ [1] , [2] , [3] , [4] , [5] ] in patients in whom other conditions, ie, plantar fasciitis, bone fractures, tendon abnormalities, and Morton neuroma, have been excluded.…”

“…Diagnostic methods have not been tested in this setting. Compression ultrasound and contrast-enhanced magnetic resonance imaging (MRI) may serve to confirm diagnosis [ [1] , [2] , [3] , [4] , [5] , [6] ]. Due to the absence of clinical data, even from cohorts of patients with distal deep vein thrombosis (DVT), no standard treatment has been established.…”

Postulating a pathophysiological association between hallux valgus and plantar venous thrombosis through cadaveric dissections – Geometric measurements pedobarographic and phlebology correlates and literature review

“…However, another study reported less than 20 cases of PVT before 2013, thereby indicating most case reports began appearing during the last two decades (Karam et al, 2013). All clinical cases of PVT documented in the recent years coincided with advances in foot venous compression imaging techniques ranging from duplex ultrasound (DUS) to MRI (Karam et al, 2013;Czihal et al, 2015;Quinn, 2018;Swellengrebel, 2019;Edwards, 2021;Rastel, 2021, Sheikh, 2022. The most remarkable aspect of PVT is its rarity, and the resultant paucity of its reporting in the contemporary literature (Karam et al, 2013;Rastel, 2021).…”

“…Since the medial plantar vein was normal, our subject can be considered a case of isolated lateral PVT. Although a few reports have described medial PVT, lateral PVT has a preponderantly higher frequency, ranging from 30% to 96% in different studies, often extending into plantar arch and metatarsal veins, and a quarter of them extending into deep calf veins (Czihal et al, 2015;Vansevenant and Vanhoenacker, 2015;Quinn, 2018;Edwards, 2021;Sheikh et al, 2022).…”