Skip to main content
Top
Published in: Journal of Medical Case Reports 1/2014

Open Access 01-12-2014 | Case report

An unusual presentation of a swollen arm: a case report

Authors: Monica Kidd, Vina Broderick

Published in: Journal of Medical Case Reports | Issue 1/2014

Login to get access

Abstract

Introduction

Subclavian vein thrombosis is a rare but potentially fatal condition that most often occurs iatrogenically or in the context of malignancy. Here we report the case of an active, healthy 32-year-old woman who presented with subtle findings of arm pain, paresthesias and skin changes of acute onset and was subsequently diagnosed with upper extremity deep vein thrombosis and subclavian stenosis, and was started on a course of oral antithrombotics.

Case presentation

A 32-year-old right-handed Caucasian woman presented to her family medicine clinic with left shoulder pain and numbness along her ipsilateral forearm and hand, as well as subtle swelling of the affected limb. Initially diagnosed with medial epicondylitis, she was later diagnosed with subclavian thrombosis caused by Paget–Schröetter syndrome.

Conclusion

Presentations such as these are often attributable to soft-tissue injuries that resolve with rest and sometimes physiotherapy. Subclavian thrombosis was a highly unexpected diagnosis in this case; however, family physicians must remain vigilant in considering rare causes of common clinical presentations which could cause patients significant morbidity if left undiagnosed.
Appendix
Available only for authorised users
Literature
1.
go back to reference Power JD, Perruccio AV, Desmeules M, Lagace C, Badley EM: Ambulatory physician care for musculoskeletal disorders in Canada. J Rheumatol. 2006, 33: 133-139.PubMed Power JD, Perruccio AV, Desmeules M, Lagace C, Badley EM: Ambulatory physician care for musculoskeletal disorders in Canada. J Rheumatol. 2006, 33: 133-139.PubMed
2.
go back to reference Illig KA, Doyle AJ: A comprehensive review of Paget–Schröetter syndrome. J Vasc Surg. 2010, 51: 1538-1547. 10.1016/j.jvs.2009.12.022.CrossRefPubMed Illig KA, Doyle AJ: A comprehensive review of Paget–Schröetter syndrome. J Vasc Surg. 2010, 51: 1538-1547. 10.1016/j.jvs.2009.12.022.CrossRefPubMed
3.
go back to reference Arnhjort T, Persson LM, Rosfors S, Ludwigs U, Larfars G: Primary deep vein thrombosis in the upper limb: a retrospective study with emphasis on pathogenesis and late sequelae. Eur J Intern Med. 2007, 18: 304-308. 10.1016/j.ejim.2006.12.005.CrossRefPubMed Arnhjort T, Persson LM, Rosfors S, Ludwigs U, Larfars G: Primary deep vein thrombosis in the upper limb: a retrospective study with emphasis on pathogenesis and late sequelae. Eur J Intern Med. 2007, 18: 304-308. 10.1016/j.ejim.2006.12.005.CrossRefPubMed
4.
go back to reference Bosma J, Vahl AC, Coveliers HME, Rauwerda JA, Wisselink W: Primary subclavian vein thrombosis and its long-term effect on quality of life. Vascular. 2011, 19: 327-332. 10.1258/vasc.2011.oa0308.CrossRefPubMed Bosma J, Vahl AC, Coveliers HME, Rauwerda JA, Wisselink W: Primary subclavian vein thrombosis and its long-term effect on quality of life. Vascular. 2011, 19: 327-332. 10.1258/vasc.2011.oa0308.CrossRefPubMed
5.
go back to reference Grant JD, Stevens SM, Woller SC, Lee EW, Kee ST, Liu DM, Lohan DG, Elliott CG: Diagnosis and management of upper extremity deep-vein thrombosis in adults. Thromb Haemost. 2012, 108: 1097-1108. 10.1160/TH12-05-0352.CrossRefPubMed Grant JD, Stevens SM, Woller SC, Lee EW, Kee ST, Liu DM, Lohan DG, Elliott CG: Diagnosis and management of upper extremity deep-vein thrombosis in adults. Thromb Haemost. 2012, 108: 1097-1108. 10.1160/TH12-05-0352.CrossRefPubMed
6.
go back to reference Spiezia L, Simioni P: Upper extremity deep vein thrombosis. Intern Emerg Med. 2010, 5: 103-109. 10.1007/s11739-009-0320-x.CrossRefPubMed Spiezia L, Simioni P: Upper extremity deep vein thrombosis. Intern Emerg Med. 2010, 5: 103-109. 10.1007/s11739-009-0320-x.CrossRefPubMed
7.
go back to reference Bates SM, Jaeschke R, Stevens SM, Goodacre S, Wells PS, Stevenson MD, Kearon C, Schunemann HJ, Crowther M, Pauker SG, Makdissi R, Guyatt GH: American College of Chest Physicians: diagnosis of DVT: antithrombotic therapy and prevention of thrombosis, 9th ed: American college of chest physicians evidence-based clinical practice guidelines. Chest. 2012, 141 (2 Suppl): e351S-e418S.CrossRefPubMedPubMedCentral Bates SM, Jaeschke R, Stevens SM, Goodacre S, Wells PS, Stevenson MD, Kearon C, Schunemann HJ, Crowther M, Pauker SG, Makdissi R, Guyatt GH: American College of Chest Physicians: diagnosis of DVT: antithrombotic therapy and prevention of thrombosis, 9th ed: American college of chest physicians evidence-based clinical practice guidelines. Chest. 2012, 141 (2 Suppl): e351S-e418S.CrossRefPubMedPubMedCentral
8.
go back to reference Kearon C: Influence of hereditary or acquired thrombophilias on the treatment of venous thromboembolism. Curr Opin Hematol. 2012, 19: 363-370. 10.1097/MOH.0b013e328356745b.CrossRefPubMed Kearon C: Influence of hereditary or acquired thrombophilias on the treatment of venous thromboembolism. Curr Opin Hematol. 2012, 19: 363-370. 10.1097/MOH.0b013e328356745b.CrossRefPubMed
9.
go back to reference Kearon C, Akl EA, Comerota AJ, Prandoni P, Bounameaux H, Goldhaber SZ, Nelson ME, Wells PS, Gould MK, Dentali F, Crowther M, Kahn SR: American college of chest physicians: antithrombotic therapy for VTE disease: antithrombotic therapy and prevention of thrombosis, 9th ed: American college of chest physicians evidence-based clinical practice guidelines. Chest. 2012, 141 (2 Suppl): e419S-e494S.CrossRefPubMedPubMedCentral Kearon C, Akl EA, Comerota AJ, Prandoni P, Bounameaux H, Goldhaber SZ, Nelson ME, Wells PS, Gould MK, Dentali F, Crowther M, Kahn SR: American college of chest physicians: antithrombotic therapy for VTE disease: antithrombotic therapy and prevention of thrombosis, 9th ed: American college of chest physicians evidence-based clinical practice guidelines. Chest. 2012, 141 (2 Suppl): e419S-e494S.CrossRefPubMedPubMedCentral
10.
go back to reference de León RA, Chang DC, Hassoun HT, Black JH, Roseborough GS, Perler BA, Rotellini-Coltvet L, Call D, Busse C, Freischlag JA: Multiple treatment algorithms for successful outcomes in venous thoracic outlet syndrome. Surgery. 2009, 145: 500-507. 10.1016/j.surg.2008.09.017.CrossRefPubMed de León RA, Chang DC, Hassoun HT, Black JH, Roseborough GS, Perler BA, Rotellini-Coltvet L, Call D, Busse C, Freischlag JA: Multiple treatment algorithms for successful outcomes in venous thoracic outlet syndrome. Surgery. 2009, 145: 500-507. 10.1016/j.surg.2008.09.017.CrossRefPubMed
11.
go back to reference Sajid MS, Ahmed N, Desai M, Baker D, Hamilton G: Upper limb deep vein thrombosis: a literature review to streamline the protocol for management. Acta Haematol. 2007, 118: 10-18. 10.1159/000101700.CrossRefPubMed Sajid MS, Ahmed N, Desai M, Baker D, Hamilton G: Upper limb deep vein thrombosis: a literature review to streamline the protocol for management. Acta Haematol. 2007, 118: 10-18. 10.1159/000101700.CrossRefPubMed
Metadata
Title
An unusual presentation of a swollen arm: a case report
Authors
Monica Kidd
Vina Broderick
Publication date
01-12-2014
Publisher
BioMed Central
Published in
Journal of Medical Case Reports / Issue 1/2014
Electronic ISSN: 1752-1947
DOI
https://doi.org/10.1186/1752-1947-8-22

Other articles of this Issue 1/2014

Journal of Medical Case Reports 1/2014 Go to the issue