Gastrocnemius Tear: Incidental Finding During a Venous Doppler Exam

2018 ◽  
Vol 42 (2) ◽  
pp. 74-77
Author(s):  
Garth S. Nanni ◽  
Stanley Ort
Keyword(s):  
Deep Vein Thrombosis ◽  
Incidental Findings ◽  
Gastrocnemius Muscle ◽  
Incidental Finding ◽  
Duplex Sonography ◽  
Popliteal Fossa ◽  
Vein Thrombosis ◽  
Muscle Tear ◽  
Complex Fluid ◽  
Deep Vein

Calf muscle tears are relatively common. They can be identified well as incidental findings using duplex sonography when performing a lower extremity venous Doppler exam. A case is presented of a 43-year-old male patient who underwent a sonogram to diagnose deep vein thrombosis. The exam results demonstrated patent and compressible common femoral, femoral, popliteal, and calf veins without evidence of deep vein thrombosis. As the sonographer was documenting the popliteal fossa, a complex fluid-filled structure within the left gastrocnemius muscle was identified. The diagnosis was reported as a gastrocnemius muscle tear. This case demonstrates a fairly common incidental finding, gastrocnemius muscle tear, when performing a venous Doppler exam.

scholarly journals Deep vein thrombosis and bilateral pulmonary embolism following minor trauma to the popliteal fossa: could this have been avoided?

CJEM ◽  
2011 ◽  
Vol 13 (02) ◽  
pp. 122-126 ◽  
Author(s):  
Jason Orlik ◽  
Jennifer McVey
Keyword(s):  
Deep Vein Thrombosis ◽  
Blunt Trauma ◽  
Pulmonary Embolus ◽  
Doppler Ultrasonography ◽  
Popliteal Fossa ◽  
Minor Trauma ◽  
Likelihood Ratios ◽  
Vein Thrombosis ◽  
Hockey Player ◽  
Deep Vein

ABSTRACT Deep vein thrombosis (DVT) with subsequent pulmonary embolus (PE) is frequently fatal if untreated. Athletes may be susceptible to DVT following minor blunt trauma to the popliteal fossa. We report an adult male hockey player with no “classic” risk factors for DVT who presented with a DVT and bilateral PE following minor popliteal blunt trauma. This case report illustrates the utility of likelihood ratios when interpreting the results of diagnostic tests such as Doppler ultrasonography.

scholarly journals Acute Deep Vein Thrombosis and Association with Popliteal Fossa (Baker's) Cysts in Patients with Lower Extremity Duplex Ultrasound Examination

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 9-10
Author(s):  
Danielle Vlazny ◽  
Damon E. Houghton ◽  
Ryan Meverden ◽  
Paul Daniels ◽  
Matthew Bartlett ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Lower Extremity ◽  
Sensitivity And Specificity ◽  
Mayo Clinic ◽  
Duplex Ultrasound ◽  
Popliteal Fossa ◽  
Popliteal Vein ◽  
Vein Thrombosis ◽  
Radiology Reports ◽  
Deep Vein

Background: Popliteal fossa cysts (PFCs aka Baker's cysts) are synovial cysts of the knee joint that can be symptomatic or asymptomatic and incidentally identified on ultrasound. Whether PFCs are associated with deep vein thrombosis (DVT) is unknown. Possible mechanisms for an association include direct compression of the popliteal vein, indirect compression on the popliteal vein with leg flexion, adjacent inflammation of the cyst, or relative immobility due to underlying joint disease itself. Methods: Lower extremity venous Duplex ultrasound radiology reports from the inception of electronic archiving through 11/14/2019 were evaluated across the Mayo Clinic Enterprise (Rochester MN, Jacksonville, FL, Scottsdale AZ, and Mayo Clinic Health System) in patients >18 years of age. Natural language processing (NLP) algorithms were created and validated to identify acute DVT (proximal or distal) and PFCs. A random sample of 1,752 ultrasound reports underwent manual review to calculate the sensitivity and specificity of the NLP algorithm. Cases (ultrasounds with acute DVT) were compared to controls (ultrasound without acute DVT) to examine the frequency of PFCs. IRB approval was obtained and patients lacking Minnesota research authorization were excluded. Results: A total of 332,016 lower extremity venous ultrasounds were performed in 223,035 patients; 156,846 unilateral and 175,170 bilateral lower extremities exams. The mean age at ultrasound was 63.3 (SD 16.5) and 54.7% were female. Ultrasound reports were available for analysis starting in 1992 with a significant increase in the number of ultrasounds performed over the study period across the enterprise (Figure 1). Overall, acute DVT was identified in 24,179 (7.3%) of ultrasounds, and PFCs were identified in 32,427 (9.8%) of ultrasounds. The sensitivity and specificity of the NLP algorithm in the full dataset to identify acute DVT was 86.0% and 97.2%, respectfully. The sensitivity and specificity of the NLP algorithm to identify PFCs was 97.8% and 99.5%, respectively. PFCs were present in 9.3% of ultrasounds with acute DVT and 9.8% of ultrasounds without acute DVT (p=0.007), OR 0.94 (95% CI 0.90-0.98). In a multivariate logistic regression model, after adjusting for age and sex, results remained significant (aOR 0.95, 95% CI 0.91-0.995). Comparing ultrasounds before and after 2010, there was a higher percentage of PFCs and acute DVT reported after 2010 (p<0.001 for both). Sensitivity analyses comparing results before or after 2010, by sex, and only in the first ultrasound performed per person, demonstrated similar results. Conclusions: PFCs are negatively associated with the presence of acute DVT on lower extremity venous Duplex ultrasound. This data does not support PFCs as a contributing or causative factor in the development of lower extremity DVT. Figure 1 Disclosures No relevant conflicts of interest to declare.

Duplex sonography phlebologically accentuated

Phlebologie ◽  
2010 ◽  
Vol 39 (03) ◽  
pp. 139-151
Author(s):  
M. Marshall
Keyword(s):  
Medical Education ◽  
Deep Vein Thrombosis ◽  
Doppler Sonography ◽  
Duplex Sonography ◽  
Disease Course ◽  
Foam Sclerotherapy ◽  
Optimal Position ◽  
Vein Thrombosis ◽  
Colour Duplex Sonography ◽  
Deep Vein

SummaryWithout any doubt colour duplex sonography was an enormous progress in angiological and/or phlebological diagnostics. Starting with the directional Doppler sonography, the large spectrum of phlebological diagnostics by colour duplex sonography is presented. Colour duplex sonography is used for a) the fundamental, morphologically and haemodynamically based diagnostics of deep vein thrombosis, of the insufficiency of subfascial and epifascial veins and for differential diagnostic delimitations (of arterial disorders, lip- and lymphedema, Baker-cysts, haematomas and so on), b) intrainterventional controls (steering of endovenous catheters and of foam sclerotherapy), c) the postinterventional assessment of results and disease course (definitively successful elimination of refluxes, relapses, complications as deep vein thrombosis and so on). Finally, the optimal position of the patient for duplex examination – supine or standing – is discussed, and methodical developments of the angiologic-phlebological diagnostics with ultrasound devices are described. Conclusion: In many cases duplexsonography avoids invasive examinations. It is part of the obligatory medical education in the field of phlebology.

scholarly journals An unusual case of duplicated popliteal vein and its effect on the diagnosis of deep vein thrombosis

2017 ◽  
Vol 16 (1) ◽  
pp. 150-153
Author(s):  
Ashwini Aithal P ◽  
Naveen Kumar ◽  
Satheesha Nayak B ◽  
Surekha D Shetty ◽  
Jyothsna Patil ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Anatomical Variation ◽  
Medical Science ◽  
Popliteal Fossa ◽  
Lower Limbs ◽  
Popliteal Vein ◽  
Vein Thrombosis ◽  
Male Cadaver ◽  
Diagnostic Ultrasonography ◽  
Deep Vein

Background: We report in here a very unusual appearance of a duplicated popliteal vein found in a male cadaver. Popliteal vein is usually a single vein present deep in the popliteal fossa which is formed by the union of venae comitantes of the anterior and posterior tibial arteries.Methods: Anatomical variation in the lower extremity was identified during routine dissection of human cadaver.Result: We noted the presence of unilateral doublepopliteal veins which were formed at the lower end of popliteal fossa. Both the veins were found closely related to the popliteal artery and both of them received tributaries. In the adductor canal both the popliteal veins joined to form the femoral vein.Conclusion: It has been believed that such venous variations in lower limbs have important implications for diagnostic ultrasonography imaging in cases which are suspected with deep vein thrombosis. Thus this case reported in here is very helpful for surgeons for proper diagnosis and management of deep vein thrombosis and also to radiologists to aid in the interpretation of venograms.Bangladesh Journal of Medical Science Vol.16(1) 2017 p.150-153

Colour-Coded Duplex Sonography in the Diagnosis of Deep Vein Thrombosis: A Comparison with Phlebography

1991 ◽  
Vol 6 (2) ◽  
pp. 103-109 ◽  
Author(s):  
A.T. Irvine ◽  
M. Lea Thomas
Keyword(s):  
Pulmonary Embolism ◽  
Deep Vein Thrombosis ◽  
Contrast Media ◽  
Diagnostic Accuracy ◽  
Femoral Vein ◽  
Accurate Method ◽  
Duplex Sonography ◽  
The Other ◽  
Vein Thrombosis ◽  
Deep Vein

A total of 50 legs in 34 consecutive patients with clinically suspected deep vein thrombosis (DVT) were evaluated both with colour-coded duplex sonography and phlebography, the tests being performed immediately following each other without the examiner knowing the result of the other procedure. Contrast phlebography was regarded as the standard for diagnosis. All the sonograms were considered to be technically adequate. The overall diagnostic accuracy, taking the leg as a whole from the ilio–femoral segment to the calf, was 92% and the sensitivity 78%. The accuracy in the femoral vein was 92%, sensitivity 64%. In the calf the accuracy was 90% and sensitivity 81%. although no attempt was made to localize or quantify the thrombus. The accuracy of the diagnosis of thrombus was not improved by the use of the colour-coded duplex facility. The main advantage of colour-coded duplex sonography over conventional duplex scanning is the easier identification of the venous system making it faster to perform. It is suggested that colour-coded sonography is a useful primary investigation for patients suspected of DVT or pulmonary embolism, but that about a third of patients will require contrast phlebography if the sonogram is negative or technically inadequate. It is emphasized that phlebography remains the most accurate method currently available for the diagnosis of DVT and using low osmolar contrast media is well tolerated and impressively safe.

Vena Cava Atresia and Deep Vein Thrombosis: A Case Report and Systematic Review

2021 ◽  
Author(s):  
V. Alende Castro ◽  
Jose Antonio Díaz-Peromingo
Keyword(s):  
Systematic Review ◽  
Deep Vein Thrombosis ◽  
Incidental Finding ◽  
Vena Cava ◽  
Young Patients ◽  
Clinical Manifestations ◽  
Thromboembolic Disease ◽  
Vein Thrombosis ◽  
Asymptomatic Patients ◽  
Deep Vein

AbstractCongenital anomalies of the vena cava often go unnoticed, and their incidental finding is frequent in imaging tests performed for another cause in asymptomatic patients. However, an association with the development of thromboembolic disease has been described, mainly in young patients.We report the case of a young woman with deep vein thrombosis associated with vena cava atresia.We conducted a search of the PubMed/Medline database. The search identified 17 articles, of which 5 were selected for extraction and data analysis. Twelve studies were excluded because they failed to match the main criteria.We identified six new cases of deep vein thrombosis associated with vena cava abnormalities, with a mean age of 42.5 years; 83.3% were male. Regarding clinical manifestations, all patients presented as deep vein thrombosis, one case of recurrence, and another case associated with the kidney and inferior vena cava abnormalities with leg thrombosis syndrome. Only one patient had a target triggering factor (cholecystectomy postoperative). The thrombophilia study was negative in all cases and none of the patients died. Treatment included enoxaparin and vitamin K antagonists.This is the first study to report on a systematic review of vena cava atresia associated with deep vein thrombosis in Spain. It shows that in this region, the disease affects young population—even in the absence of risk factors—and is linked to a low mortality. The most frequent presentation form was deep vein thrombosis. Therefore, congenital abnormalities of the vena cava should be suspected in young patients with thromboembolic disease, due to their implications regarding to the duration of anticoagulant treatment, as well as their possible association with other prothrombotic factors.

Musculotendinous Disorders in the Lower Leg

2017 ◽  
Vol 21 (04) ◽  
pp. 433-442
Author(s):  
Joel Newman
Keyword(s):  
Deep Vein Thrombosis ◽  
Gastrocnemius Muscle ◽  
Soft Tissue Injuries ◽  
Lower Leg ◽  
Vein Thrombosis ◽  
Medial Head ◽  
Athletic Activities ◽  
Deep Vein ◽  
Calf Pain ◽  
Calf Muscles

AbstractMusculotendinous injury in the lower leg is associated with a variety of athletic activities. Myotendinous strain is typically localized to the posterior calf muscles, with involvement of the medial head of gastrocnemius muscle most common. Nontraumatic soft tissue injuries of the lower leg, including muscle herniation, are less frequently imaged. Ruptured popliteal cysts and deep vein thrombosis are important differential considerations in the patient presenting with acute calf pain and swelling.

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