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Point-Of-Care Ultrasound Screening for Proximal Lower Extremity Deep Venous Thrombosis
Published on: February 10, 2023
Unsuspected lower extremity deep venous thrombosis simulating musculoskeletal pathology
Antoni J Parellada1, William B Morrison, Sean B Reiter
1DII - Diagnostic Imaging, Inc., Department of Radiology, Frankford Hospitals, Torresdale Campus, Red Lion and Knights Roads, Philadelphia, PA 19114, USA. aparellada@diiradiology.com
Skeletal Radiology
|May 26, 2006
Summary
Magnetic Resonance Imaging (MRI) can diagnose unsuspected deep venous thrombosis (DVT) presenting as muscle edema. Careful review of MRI scans is crucial for identifying intramuscular venous thrombosis, even when clinical suspicion for DVT is absent.
Area of Science:
- Radiology
- Vascular Imaging
- Musculoskeletal Imaging
Background:
- Deep venous thrombosis (DVT) is often clinically unsuspected.
- Musculoskeletal injuries are common differential diagnoses for lower extremity pain and swelling.
Purpose of the Study:
- To emphasize the role of MRI in diagnosing unsuspected lower extremity DVT.
- To highlight the importance of detecting intramuscular venous thrombosis on MRI.
Main Methods:
- Retrospective review of MRI studies in four patients with unsuspected DVT.
- Consensus review by two musculoskeletal radiologists.
- Comparison of MRI findings with subsequent ultrasound in some cases.
Main Results:
- All patients presented with significant soft tissue or muscle edema on MRI.
- MRI revealed intramuscular venous thrombosis in three patients and popliteal vein distension in one.
- Ultrasound confirmed MRI findings in three patients, but did not show extension of intramuscular thrombosis to deep venous trunks.
Conclusions:
- Intramuscular venous thrombosis can mimic primary musculoskeletal conditions on MRI due to edema.
- Identifying rim-enhancing, branching intramuscular tubular structures on MRI is key for diagnosing DVT without clinical suspicion.
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