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Skeletal Radiology
Published in: Skeletal Radiology 7/2023

19-12-2022 | Venous Thrombosis | Review Article

Venous thrombosis: a mimic of musculoskeletal injury on MR imaging

Authors: Renata Vidal Leão, Eduarda Castelo Branco Araujo Bernal, Marcelo Bordalo Rodrigues, Denise Tokechi Amaral, Marcos Felippe de Paula Correa, Paulo Victor Partezani Helito

Published in: Skeletal Radiology | Issue 7/2023

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Abstract

Clinical signs and symptoms of venous thrombosis and musculoskeletal pathologies frequently overlap. Sometimes, patients with venous thrombosis undergo MR examinations under an equivocal suspicion of muscle, tendon or articular injury. A low pretest clinical suspicion and lack of familiarity with the conventional MR imaging signs of venous thrombosis may result in failure to diagnose venous thrombosis, delaying treatment and raising morbimortality. In MR imaging, thrombosis presents as venous ectasia with intraluminal heterogeneous content. Small vein thrombosis is often identified as having a branching aspect. Perivenous edema and inflammatory soft tissue changes may be the most prominent findings. The purpose of this paper is to illustrate MR findings of venous thrombosis in patients who underwent MR examinations due to suspected musculoskeletal pathologies. Cases of venous thrombosis in different sites of the body diagnosed through MR are presented.
Literature
1.
Delgado GJ, Chung CB, Lektrakul N, Azocar P, Botte MJ, Coria D, et al. Tennis leg: clinical US study of 141 patients and anatomic investigation of four cadavers with MR imaging and US. Radiology. 2002;224(1):112–9.PubMed
2.
Hull R, Hirsh J, Sackett DL, Taylor DW, Carter C, Turpie AG, et al. Clinical validity of a negative venogram in patients with clinically suspected venous thrombosis. Circulation. 1981;64(3):622–5.PubMed
3.
Parellada AJ, Morrison WB, Reiter SB, Carrino JA, Glickman PL, Kloss LA, et al. Unsuspected lower extremity deep venous thrombosis simulating musculoskeletal pathology. Skeletal Radiol. 2006;35(9):659–64.PubMed
4.
Nielsen JD. The incidence of pulmonary embolism during deep vein thrombosis. Phlebology. 2013;28(Suppl 1):29–33.PubMed
5.
Silverstein MD, Heit JA, Mohr DN, Petterson TM, O’Fallon WM, Melton LJ. Trends in the incidence of deep vein thrombosis and pulmonary embolism: a 25-year population-based study. Arch Intern Med. 1998;158(6):585–93.PubMed
6.
Anderson FA, Wheeler HB, Goldberg RJ, Hosmer DW, Patwardhan NA, Jovanovic B, et al. A population-based perspective of the hospital incidence and case-fatality rates of deep vein thrombosis and pulmonary embolism. The Worcester DVT Study. Arch Intern Med. 1991;151(5):933–8.PubMed
7.
Galanaud JP, Bosson JL, Genty C, Presles E, Cucherat M, Sevestre MA, et al. Superficial vein thrombosis and recurrent venous thromboembolism: a pooled analysis of two observational studies. J Thromb Haemost. 2012;10(6):1004–11.PubMed
8.
Galanaud JP, Sevestre MA, Pernod G, Kahn SR, Genty C, Terrisse H, et al. Long-term risk of venous thromboembolism recurrence after isolated superficial vein thrombosis. J Thromb Haemost. 2017;15(6):1123–31.PubMed
9.
Spritzer CE, Sostman HD, Wilkes DC, Coleman RE. Deep venous thrombosis: experience with gradient-echo MR imaging in 66 patients. Radiology. 1990;177(1):235–41.PubMed
10.
Wang MS, Haynor DR, Wilson GJ, Maki JH. Intravascular hematocrit layering in equilibrium phase contrast-enhanced MR angiography of the peripheral vasculature. J Magn Reson Imaging. 2006;24(6):1393–400.PubMed
11.
Ambrose N, Pierce IT, Gatehouse PD, Haskard DO, Firmin DN. Magnetic resonance imaging of vein wall thickness in patients with Behçet’s syndrome. Clin Exp Rheumatol. 2014;32(4 Suppl 84):S99-102.PubMed
12.
Evans AJ, Sostman HD, Witty LA, Paulson EK, Spritzer CE, Hertzberg BS, et al. Detection of deep venous thrombosis: prospective comparison of MR imaging and sonography. J Magn Reson Imaging. 1996;6(1):44–51.PubMed
13.
Fraser DG, Moody AR, Davidson IR, Martel AL, Morgan PS. Deep venous thrombosis: diagnosis by using venous enhanced subtracted peak arterial MR venography versus conventional venography. Radiology. 2003;226(3):812–20.PubMed
14.
Jensen AD, Borris LC, Christiansen TM, Lundorf E. Accuracy of magnetic resonance imaging in the diagnosis of deep vein thrombosis in asymptomatic patients with injuries of the lower extremity. Pilot Study Thromb Res. 2001;101(6):423–6.PubMed
15.
Duncan DP, Taddonio M, Chang EY, Huang BK. Characterization of intramuscular calf vein thrombosis on routine knee MRI. Skeletal Radiol. 2019;48(10):1573–80.PubMed
16.
Schulman S, Granqvist S, Juhlin-Dannfelt A, Lockner D. Long-term sequelae of calf vein thrombosis treated with heparin or low-dose streptokinase. Acta Med Scand. 1986;219(4):349–57.PubMed
17.
Liu PT, Ilaslan H. Unicompartmental muscle edema: an early sign of deep venous thrombosis. Skeletal Radiol. 2003;32(1):41–5.PubMed
18.
Labropoulos N, Webb KM, Kang SS, Mansour MA, Filliung DR, Size GP, et al. Patterns and distribution of isolated calf deep vein thrombosis. J Vasc Surg. 1999;30(5):787–91.PubMed
19.
Turpie AG, Esmon C. Venous and arterial thrombosis–pathogenesis and the rationale for anticoagulation. Thromb Haemost. 2011;105(4):586–96.PubMed
20.
Joffe HV, Goldhaber SZ. Upper-extremity deep vein thrombosis. Circulation. 2002;106(14):1874–80.PubMed
21.
Kim HY, Cho EB, Youn SH, Park EJ, Kwon IH, Kim KH, et al. Two cases of thrombosis of the palmar digital vein. Ann Dermatol. 2012;24(3):351–4.PubMedPubMedCentral
22.
Decousus H, Quéré I, Presles E, Becker F, Barrellier MT, Chanut M, et al. Superficial venous thrombosis and venous thromboembolism: a large, prospective epidemiologic study. Ann Intern Med. 2010;152(4):218–24.PubMed
23.
Miranda FC, Carneiro RD, Longo CH, Fernandes TD, Rosemberg LA, de GusmãoFunari MB. Plantar thrombophlebitis: magnetic resonance imaging findings. Rev Bras Ortop. 2012;47(6):765–9.PubMed
24.
Vansevenant M, Vanhoenacker FM. Plantar vein thrombosis: an unusual cause of plantar pain. J Belg Soc Radiol. 2015;99(2):98–101.PubMedPubMedCentral
25.
Long A, Bura-Riviere A, Sapoval M. Plantar venous thrombosis and anticardiolipin antibody syndrome. Case report. J Mal Vasc. 2004;29(1):39–40.PubMed
26.
Barros MV, Labropoulos N. Plantar vein thrombosis–evaluation by ultrasound and clinical outcome. Angiology. 2010;61(1):82–5.PubMed
27.
Czihal M, Röling J, Rademacher A, Schröttle A, Kuhlencordt P, Hoffmann U. Clinical characteristics and course of plantar vein thrombosis: a series of 22 cases. Phlebology. 2015;30(10):714–8.PubMed
28.
Karam L, Tabet G, Nakad J, Gerard JL. Spontaneous plantar vein thrombosis: state of the art. Phlebology. 2013;28(8):432–7.PubMed
29.
Geiger C, Rademacher A, Chappell D, Sadeghi-Azandaryani M, Heyn J. Plantar vein thrombosis due to busy night duty on intensive care unit. Clin Appl Thromb Hemost. 2011;17(2):232–4.PubMed
30.
Bernathova M, Bein E, Bendix N, Bodner G. Sonographic diagnosis of plantar vein thrombosis: report of 3 cases. J Ultrasound Med. 2005;24(1):101–3.PubMed
31.
Barros M, Nascimento I, Barros T, Labropoulos N. Plantar vein thrombosis and pulmonary embolism. Phlebology. 2015;30(1):66–9.PubMed
32.
Natarajan A, Amarvathi R, Philip B, Rozario A. Ruptured Baker’s cyst simulating deep venous thrombosis. Trop Doct. 2003;33(2):106–7.PubMed
33.
34.
Shulman RM, Buchan C, Bleakney RR, White LM. Low prevalence of unexpected popliteal DVT detected on routine MRI assessment of the knee. Clin Imaging. 2016;40(1):79–85.PubMed
35.
Schmitt HE, Mihatsch MJ. Thrombosis of the popliteal vein. Cardiovasc Intervent Radiol. 1992;15(4):234–9.PubMed
36.
Chaudhuri R, Salari R. Baker’s cyst simulating deep vein thrombosis. Clin Radiol. 1990;41(6):400–4.PubMed
37.
Ozgocmen S, Kocakoc E, Kiris A, Ardicoglu O. Pseudothrombophlebitis in a patient with Behçet’s syndrome: Doppler ultrasound and magnetic resonance imaging findings. Clin Rheumatol. 2002;21(1):60–2.PubMed
38.
Miller TT, Staron RB, Koenigsberg T, Levin TL, Feldman F. MR imaging of Baker cysts: association with internal derangement, effusion, and degenerative arthropathy. Radiology. 1996;201(1):247–50.PubMed
39.
Herman AM, Marzo JM. Popliteal cysts: a current review. Orthopedics. 2014;37(8):e678-684.PubMed
40.
Lazarus ML, Ray CE, Maniquis CG. MRI findings of concurrent acute DVT and dissecting popliteal cyst. Magn Reson Imaging. 1994;12(1):155–8.PubMed
41.
Campbell JT. Posterior calf injury. Foot Ankle Clin. 2009;14(4):761–71.PubMed
42.
Kret MR, Liem TK, Mitchell EL, Landry GJ, Moneta GL. Isolated calf muscular vein thrombosis is associated with pulmonary embolism and a high incidence of additional ipsilateral and contralateral deep venous thrombosis. J Vasc Surg Venous Lymphat Disord. 2013;1(1):33–8.PubMed
43.
Spritzer CE, Arata MA, Freed KS. Isolated pelvic deep venous thrombosis: relative frequency as detected with MR imaging. Radiology. 2001;219(2):521–5.PubMed
44.
Theiss JL, Fink ML, Gerber JP. Deep vein thrombosis in a young marathon athlete. J Orthop Sports Phys Ther. 2011;41(12):942–7.PubMed
45.
Yim ES, Friedberg RP. Case report: lower extremity deep vein thrombosis following an intense calf workout. Curr Sports Med Rep. 2012;11(6):282–6.PubMed
46.
Rodger MA, Avruch LI, Howley HE, Olivier A, Walker MC. Pelvic magnetic resonance venography reveals high rate of pelvic vein thrombosis after cesarean section. Am J Obstet Gynecol. 2006;194(2):436–7.PubMed
47.
Gary T, Steidl K, Belaj K, Hafner F, Froehlich H, Deutschmann H, et al. Unusual deep vein thrombosis sites: magnetic resonance venography in patients with negative compression ultrasound and symptomatic pulmonary embolism. Phlebology. 2014;29(1):25–9.PubMed
48.
Ouriel K, Green RM, Greenberg RK, Clair DG. The anatomy of deep venous thrombosis of the lower extremity. J Vasc Surg. 2000;31(5):895–900.PubMed
49.
Lutterbach-Penna RA, Kalume-Brigido M, Robertson BL, Jacobson JA, Girish G, Fessell DP. Deep vein thrombosis simulating hamstring injury on sonography. J Ultrasound Med. 2012;31(4):660–2.PubMed
50.
Lee YS, Kim J, Jeong JJ. Deep vein thrombosis in the thigh: MR imaging in two cases with atypical presentations. Skeletal Radiol. 2022;51(7):1511–6.PubMed
51.
Stamatakis JD, Kakkar VV, Sagar S, Lawrence D, Nairn D, Bentley PG. Femoral vein thrombosis and total hip replacement. Br Med J. 1977;2(6081):223–5.PubMedPubMedCentral
52.
Şener S, Demirhan N. An uncommon cause of hip pain: isolated gluteal deep venous thrombosis associated with prolonged seated immobility. Turk J Thorac Cardiovasc Surg. 2013;21(2):497–9.
53.
Papastergiou SG, Koukoulias NE, Tsitouridis I, Natsis C, Parisis CA. Circumflex femoral vein thrombosis misinterpreted as acute hamstring strain. Br J Sports Med. 2007;41(7):460–1.PubMedPubMedCentral
54.
Brown SC, Gewillig M. Ever heard of the obturator vein? Catheter Cardiovasc Interv. 2010;75(3):416–9.PubMed
55.
Ploton G, Pistorius MA, Raimbeau A, Denis Le Seve J, Bergère G, Ngohou C, et al. A STROBE cohort study of 755 deep and superficial upper-extremity vein thrombosis. Medicine (Baltimore). 2020;99(6):e18996.PubMed
56.
Feinberg J, Nielsen EE, Jakobsen JC. Thrombolysis for acute upper extremity deep vein thrombosis. Cochrane Database Syst Rev. 2017;12:CD012175.PubMed
57.
Kucher N. Clinical practice. Deep-vein thrombosis of the upper extremities. N Engl J Med. 2011;364(9):861–9.PubMed
58.
59.
Alla VM, Natarajan N, Kaushik M, Warrier R, Nair CK. Paget-schroetter syndrome: review of pathogenesis and treatment of effort thrombosis. West J Emerg Med. 2010;11(4):358–62.PubMedPubMedCentral
60.
van Rossum M, van der Lei B, van Wingerden JJ. Thrombosis of the palmar digital veins: a report of 6 cases and a review of the literature. Ann Plast Surg. 2005;55(6):629–32.PubMed
61.
Hofer T. Palmar digital vein thromboses: their different expressions. Dermatology. 2002;204(3):240–3.PubMed
Metadata
Title
Venous thrombosis: a mimic of musculoskeletal injury on MR imaging
Authors
Renata Vidal Leão
Eduarda Castelo Branco Araujo Bernal
Marcelo Bordalo Rodrigues
Denise Tokechi Amaral
Marcos Felippe de Paula Correa
Paulo Victor Partezani Helito
Publication date
19-12-2022
Publisher
Springer Berlin Heidelberg
Published in
Skeletal Radiology / Issue 7/2023
Print ISSN: 0364-2348
Electronic ISSN: 1432-2161
DOI
https://doi.org/10.1007/s00256-022-04258-4

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