Advisor Information
Adam Rosen
Location
Dr. C.C. and Mabel L. Criss Library
Presentation Type
Poster
Start Date
2-3-2018 12:30 PM
End Date
2-3-2018 1:45 PM
Abstract
A NCAA Division I baseball middle infielder complained of discomfort in his right upper extremity. He reported no specific mechanism of injury. He had a history of right elbow fracture at age eight with joint displacement. However, no other previous injury to his upper extremity was reported. He did not feel any pain or abnormal sensations while exercising, but noted some discomfort in the right arm, shoulder and pectoral muscles afterward. The evaluating athletic trainer also noted obvious swelling and discoloration of the right arm, bilaterally different temperature, decreased radial pulse, and positive Roo’s and Adson’s Tests. The venous duplex scan showed superficial thrombophlebitis in the basilic vein and superficial vein thrombosis. He was started on aspirin (81 mg per day) and instructed to discontinue weightlifting. On the second visit, a venogram revealed a thrombosis of the right axillary and subclavian vein with multiple collateral vessels. He was started on Plavix (75 mg a day), Xifaxan (550 mg three times daily) and told to return slowly to activity. At specialized vascular clinic, he was diagnosed with Paget-Schroetter’s syndrome. He was prescribed Xarelto (15 mg a day) and an arm sleeve with a gauntlet. He was sent to a physical therapist to complete rehabilitation. Pulsed non-thermal ultrasound was used. After three months, a CT venogram demonstrated that his right subclavian vein was not recanalized, but numerous new collaterals had developed. He returned to normal practice after four months from the initial diagnosis.
Venous Thoracic Outlet Syndrome with Paget-Schroetter’s Syndrome in a Male Collegiate Baseball Player
Dr. C.C. and Mabel L. Criss Library
A NCAA Division I baseball middle infielder complained of discomfort in his right upper extremity. He reported no specific mechanism of injury. He had a history of right elbow fracture at age eight with joint displacement. However, no other previous injury to his upper extremity was reported. He did not feel any pain or abnormal sensations while exercising, but noted some discomfort in the right arm, shoulder and pectoral muscles afterward. The evaluating athletic trainer also noted obvious swelling and discoloration of the right arm, bilaterally different temperature, decreased radial pulse, and positive Roo’s and Adson’s Tests. The venous duplex scan showed superficial thrombophlebitis in the basilic vein and superficial vein thrombosis. He was started on aspirin (81 mg per day) and instructed to discontinue weightlifting. On the second visit, a venogram revealed a thrombosis of the right axillary and subclavian vein with multiple collateral vessels. He was started on Plavix (75 mg a day), Xifaxan (550 mg three times daily) and told to return slowly to activity. At specialized vascular clinic, he was diagnosed with Paget-Schroetter’s syndrome. He was prescribed Xarelto (15 mg a day) and an arm sleeve with a gauntlet. He was sent to a physical therapist to complete rehabilitation. Pulsed non-thermal ultrasound was used. After three months, a CT venogram demonstrated that his right subclavian vein was not recanalized, but numerous new collaterals had developed. He returned to normal practice after four months from the initial diagnosis.