Plantar vein thrombosis provoked by mechanical strain to the foot: a rare cause of plantar heel pain

Abstract

A 61-year-old mountain hiker presented with acute pain of the medial-plantar aspect of the right foot. As the location, intensity and acute onset of the pain were atypical for fasciitis plantaris, an ultrasound was performed. This demonstrated a segmental plantar vein thrombosis (PVT), which was confirmed on consequent MRI. Patient was a non-smoker, without a medical or family history of coagulopathies. Four months previously, he suffered from metatarsalgia of the left, thus contralateral, foot, which prompted treatment with bilateral orthoses. In addition to metatarsal padding, medial-arch support was prescribed due to the presence of flexible flatfeet. Following internal medicine consultation, treatment consisted of discontinuing the use of orthoses, rest and non-steroidal anti-inflammatory drugs (NSAIDs). At 2-week follow-up, the patient was pain-free. In this case report, PVT, a rare cause for plantar heel pain, is discussed. In addition, a summary of the diagnosis and treatment of PVT is outlined.

Plantar vein thrombosis

“…8 Other causes include athletic activity, 4 post-operative immobilisation, 3,11 coagulation disorder anticardiolipin antibody syndrome, 12 prothrombin G20210A mutation, 13 paraneoplastic syndrome in a patient with bone metastasis, 14 pressure from orthotics 15 and pressure from footwear. 16…”

“…Swellengrebel et al. 16 reported a 61 year old male who presented to an outpatient clinic with severe pain of the medial plantar aspect of his right foot. The pain started abruptly five days prior without any preceding trauma.…”

Plantar vein thrombosis masquerading as plantar fasciitis: A case report

“…9 Other causes include athletic activity, 4 immobilisation, 3,11 anticardiolipin antibody syndrome, 12 prothrombin G20210A mutation, 13 paraneoplastic syndrome, 14 orthotics 15 and footwear. 16…”

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).…”