Upper Extremity Effort Thrombosis

2020 ◽  
Vol 50 (9) ◽  
pp. 532-532
Author(s):  
John D. Garbrecht ◽  
William Reynolds ◽  
Michael D. Rosenthal
Keyword(s):  
Upper Extremity ◽  
Effort Thrombosis

scholarly journals Upper extremity deep venous thrombosis: risk factors, diagnosis, treatment

2016 ◽  
Vol 11 (1) ◽  
pp. 28-32
Author(s):  
Camelia C. DIACONU ◽  
◽  
Mădălina ILIE ◽  
Mihaela Adela IANCU ◽  
◽  
...  
Keyword(s):  
Risk Factors ◽  
Pulmonary Embolism ◽  
High Risk ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Upper Extremity ◽  
Brachiocephalic Vein ◽  
Risk Of Death ◽  
Thrombosis Risk ◽  
Effort Thrombosis

Upper extremity deep venous thrombosis is a condition with increasing prevalence, with high risk of morbidity and mortality, due to embolic complications. In the majority of the cases, thrombosis involves more than one venous segment, most frequently being affected the subclavian vein, followed by internal jugular vein, brachiocephalic vein and basilic vein. Upper extremity deep venous thrombosis in patients without risk factors for thrombosis is called primary deep venous thrombosis and includes idiopathic thrombosis and effort thrombosis. Deep venous thrombosis of upper extremity is called secondary when there are known risk factors and it is encountered mainly in older patients, with many comorbidities. The positive diagnosis is established only after paraclinical and imaging investigations, ultrasonography being the most useful diagnostic method. The most important complication, with high risk of death, is pulmonary embolism. Treatment consists in anticoagulant therapy, for preventing thrombosis extension and pulmonary embolism.

Effort Thrombosis in the Elite Throwing Athlete

2002 ◽  
Vol 30 (5) ◽  
pp. 708-712 ◽  
Author(s):  
Gregory S. DiFelice ◽  
George A. Paletta ◽  
Barry B. Phillips ◽  
Rick W. Wright
Keyword(s):  
Upper Extremity ◽  
Retrospective Review ◽  
Clinical Symptoms ◽  
Division I ◽  
Baseball Players ◽  
Throwing Athlete ◽  
Effort Thrombosis ◽  
Previous Level ◽  
Clinical Conditions ◽  
First Rib Resection

Background: Upper extremity vascular injuries are uncommon in the elite throwing athlete. However, the extreme stresses that are placed on the upper extremity of elite baseball players, especially pitchers, puts them at risk for such injuries. One such injury is upper extremity venous thrombosis or “effort thrombosis.” Purpose: We wanted to review the common initial clinical symptoms and physical examination findings of effort thrombosis in elite baseball players and to review the associated clinical conditions such as hypercoagulable states and pulmonary embolism. Study Design: Retrospective review of a series of cases. Methods: A retrospective review of the medical records of a Major League Baseball organization and a Division I college was performed for the period 1987 to 1997. Results: We located four cases of effort thrombosis involving elite baseball players. Contrast venography was used to confirm the diagnosis in all cases. All patients were successfully treated with transluminal catheter-directed urokinase thrombolysis followed by first rib resection and systemic anticoagulant therapy for up to 3 months. All four players returned to play at or above their previous level of competition with no long-term chronic sequelae. Conclusions: Prompt clinical recognition, diagnosis, and treatment of effort thrombosis in the elite baseball player provides the player with an excellent prognosis for return to the previous level of play.

scholarly journals Effort Thrombosis Presenting as Pulmonary Embolism in a Professional Baseball Pitcher

2009 ◽  
Vol 1 (6) ◽  
pp. 493-499 ◽  
Author(s):  
Brandon D. Bushnell ◽  
Adam W. Anz ◽  
Keith Dugger ◽  
Gary A. Sakryd ◽  
Thomas J. Noonan
Keyword(s):  
Pulmonary Embolism ◽  
Upper Extremity ◽  
Thoracic Outlet Syndrome ◽  
Rapid Diagnosis ◽  
Professional Baseball ◽  
Shortness Of Breath ◽  
Baseball Pitcher ◽  
Effort Thrombosis ◽  
Major League ◽  
Professional Baseball Pitcher

Context: Effort thrombosis, or Paget-Schroetter’s syndrome, is a rare subset of thoracic outlet syndrome in which deep venous thrombosis of the upper extremity occurs as the result of repetitive overhead motion. It is occasionally associated with pulmonary embolism. This case of effort thrombosis and pulmonary embolus was in a 25-year-old major league professional baseball pitcher, in which the only presenting complaints involved dizziness and shortness of breath without complaints involving the upper extremity—usually, a hallmark of most cases of this condition. The patient successfully returned to play for 5 subsequent seasons at the major league level after multimodal treatment that included surgery for thoracic outlet syndrome. Objective: Though rare, effort thrombosis should be included in the differential diagnosis of throwing athletes with traditional extremity-focused symptoms and in cases involving pulmonary or thoracic complaints. Rapid diagnosis is a critical component of successful treatment.

scholarly journals Upper Extremity Deep Vein Thromboses: The Bowler and the Barista

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Seth Stake ◽  
Anne L. du Breuil ◽  
Jeremy Close
Keyword(s):  
Differential Diagnosis ◽  
Literature Review ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Upper Extremity ◽  
Upper Limb ◽  
Elite Athletes ◽  
Effort Thrombosis ◽  
Deep Vein ◽  
Deep Vein Thromboses

Effort thrombosis of the upper extremity refers to a deep venous thrombosis of the upper extremity resulting from repetitive activity of the upper limb. Most cases of effort thrombosis occur in young elite athletes with strenuous upper extremity activity. This article reports two cases who both developed upper extremity deep vein thromboses, the first being a 67-year-old bowler and the second a 25-year-old barista, and illustrates that effort thrombosis should be included in the differential diagnosis in any patient with symptoms concerning DVT associated with repetitive activity. A literature review explores the recommended therapies for upper extremity deep vein thromboses.

scholarly journals Effort thrombosis of the upper extremity in a young sportsman: Paget Schroetter syndrome * COMMENTARY

2007 ◽  
Vol 41 (8) ◽  
pp. 540-541 ◽  
Author(s):  
G. Roche-Nagle ◽  
R. Ryan ◽  
M. Barry ◽  
D. Brophy ◽  
L. G Rocke
Keyword(s):  
Upper Extremity ◽  
Effort Thrombosis

Primary upper extremity deep vein thrombosis (effort thrombosis)

2021 ◽  
Vol 20 (2) ◽  
pp. 151-154
Author(s):  
SM Ramadan ◽  
◽  
EV Kasfiki ◽  
CWP Kelly ◽  
I Ali ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Upper Extremity ◽  
Treatment Options ◽  
Young Male ◽  
Healthy Male ◽  
Vein Thrombosis ◽  
Effort Thrombosis ◽  
Arm Swelling ◽  
Uncommon Condition ◽  
Deep Vein

Primary spontaneous upper extremity deep vein thrombosis is characterised by thrombosis within deep veins draining the upper extremity due to anatomical abnormalities of the thoracic outlet causing axillosubclavian compression and subsequent thrombosis. It is an uncommon condition that typically presents with unilateral arm swelling in a young male following vigorous upper extremity activity. The diagnosis of this condition is usually made by Doppler ultrasound, but other investigations are mandatory to exclude the secondary causes of upper extremity DVT. Different treatment options are available including anticoagulation, thrombolysis, and surgery. We report the case of a young healthy male with athletic physique who presented with pain and swelling of his dominant arm after weightlifting in the gym.

scholarly journals Soccer player with unusual right shoulder and arm pain and swelling

2020 ◽  
Vol 12 (2) ◽  
pp. 181
Author(s):  
Alan Zakaria ◽  
Jasper Gill ◽  
Livia Maruoka Nishi ◽  
Jeff Nadwodny ◽  
George G. A. Pujalte
Keyword(s):  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Upper Extremity ◽  
Soccer Player ◽  
Early Recognition ◽  
Thoracic Inlet ◽  
Arm Pain ◽  
First Rib ◽  
Effort Thrombosis ◽  
First Rib Resection

ABSTRACT INTRODUCTIONPaget-Schroetter syndrome, or effort thrombosis, refers to a deep venous thrombosis in an upper extremity. It is most commonly located in the axillary or subclavian veins and is associated with vigorous repetitive movements and anatomic abnormalities. CASE PRESENTATIONThis case study describes an 18-year-old Division 1 soccer player who presented with worsening axillary swelling and pain. He was found to have subclavian stenosis at the level of the thoracic inlet between the clavicle and first rib, with deep venous thrombosis in his right axillary, subclavian, proximal brachial, and basilic veins. It was diagnosed with ultrasound and confirmed with venography. He was treated initially with enoxaparin and warfarin before having mechanical thrombolysis, balloon venoplasty, infusion of tissue plasminogen activator, and a right first rib resection. CONCLUSIONAs Paget-Schroetter syndrome is rare, early recognition and management leads to fewer long-lasting sequelae and less morbidity. Left untreated, it can result in pulmonary embolism and residual upper extremity obstruction.

Combining Values

2002 ◽  
Vol 7 (2) ◽  
pp. 1-4, 12 ◽  
Author(s):  
Christopher R. Brigham
Keyword(s):  
Lower Extremity ◽  
Upper Extremity ◽  
Evaluation Method ◽  
Proximal Phalanx ◽  
Common Error ◽  
The Third ◽  
Whole Person ◽  
Impairment Ratings ◽  
Upper Extremity Impairment ◽  
The Individual

Abstract To account for the effects of multiple impairments, evaluating physicians must provide a summary value that combines multiple impairments so the whole person impairment is equal to or less than the sum of all the individual impairment values. A common error is to add values that should be combined and typically results in an inflated rating. The Combined Values Chart in the AMA Guides to the Evaluation of Permanent Impairment, Fifth Edition, includes instructions that guide physicians about combining impairment ratings. For example, impairment values within a region generally are combined and converted to a whole person permanent impairment before combination with the results from other regions (exceptions include certain impairments of the spine and extremities). When they combine three or more values, physicians should select and combine the two lowest values; this value is combined with the third value to yield the total value. Upper extremity impairment ratings are combined based on the principle that a second and each succeeding impairment applies not to the whole unit (eg, whole finger) but only to the part that remains (eg, proximal phalanx). Physicians who combine lower extremity impairments usually use only one evaluation method, but, if more than one method is used, the physician should use the Combined Values Chart.

Impairment Tutorial: Functionally Limiting Upper Extremity Pain: Controversies in Impairment Rating

2003 ◽  
Vol 8 (5) ◽  
pp. 4-12
Author(s):  
Lorne Direnfeld ◽  
James Talmage ◽  
Christopher Brigham
Keyword(s):  
Upper Extremity ◽  
Radicular Pain ◽  
Illness Behavior ◽  
Orthopedic Surgeon ◽  
First Case ◽  
Clinical Presentations ◽  
Whole Person ◽  
Physical Examinations ◽  
Upper Extremity Impairment ◽  
The Individual

Abstract This article was prompted by the submission of two challenging cases that exemplify the decision processes involved in using the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides). In both cases, the physical examinations were normal with no evidence of illness behavior, but, based on their histories and clinical presentations, the patients reported credible symptoms attributable to specific significant injuries. The dilemma for evaluators was whether to adhere to the AMA Guides, as written, or to attempt to rate impairment in these rare cases. In the first case, the evaluating neurologist used alternative approaches to define impairment based on the presence of thoracic outlet syndrome and upper extremity pain, as if there were a nerve injury. An orthopedic surgeon who evaluated the case did not base impairment on pain and used the upper extremity chapters in the AMA Guides. The impairment ratings determined using either the nervous system or upper extremity chapters of the AMA Guides resulted in almost the same rating (9% vs 8% upper extremity impairment), and either value converted to 5% whole person permanent impairment. In the second case, the neurologist evaluated the individual for neuropathic pain (9% WPI), and the orthopedic surgeon rated the patient as Diagnosis-related estimates Cervical Category II for nonverifiable radicular pain (5% to 8% WPI).

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