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.

scholarly journals A Case Report on VT from TV: DVT and PE from Prolonged Television Watching

2017 ◽  
Vol 2017 ◽  
pp. 1-3
Author(s):  
Alan Lucerna ◽  
James Espinosa ◽  
Lindsey Ackley ◽  
Philip Carhart ◽  
Douglas Stranges ◽  
...  
Keyword(s):  
Risk Factors ◽  
Emergency Department ◽  
Deep Vein Thrombosis ◽  
Case Report ◽  
Pulmonary Embolus ◽  
Thromboembolic Events ◽  
Television Watching ◽  
Vein Thrombosis ◽  
Deep Vein ◽  
Made In

Pulmonary embolus (PE) and deep vein thrombosis are diagnoses that are commonly made in the emergency department. Well known risk factors for thromboembolic events include immobility, malignancy, pregnancy, surgery, and acquired or inherited thrombophilias, obesity, cigarette smoking, and hypertension. We present a case of a 59-year-old female who watched TV and developed leg swelling and was found to have PE and DVT.

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 in the Uninjured Limb in Patients with Lower Extremity Fractures: A Retrospective Study

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Peng-Fei Wang ◽  
Jia-Hao Li ◽  
Chen Fei ◽  
Zhi Li ◽  
Chao Ke ◽  
...  
Keyword(s):  
Risk Factors ◽  
Deep Vein Thrombosis ◽  
Lower Extremity ◽  
Doppler Ultrasonography ◽  
Vein Thrombosis ◽  
Independent Risk Factors ◽  
Level 1 ◽  
Deep Vein ◽  
Actual Incidence ◽  
D Dimer

Objective. This study is aimed at investigating the incidence of deep vein thrombosis (DVT) in the uninjured limb during hospitalization and 1 month after surgery in patients with lower extremity fractures. Methods. We collected the clinical data of patients with lower extremity fractures in Xi’an Honghui Hospital. Doppler ultrasonography was used to diagnose DVT. According to the results of ultrasonography, the patients were divided into two groups: uninjured limb with DVT group and uninjured limb without DVT group. Results. A total of 494 patients who met all inclusion criteria were included in this study. The incidence rate of DVT in the uninjured limb was 19.84% and 18.83% during hospitalization and 1 month after surgery, respectively. Age (OR=1.035, 95% CI: 1.013–1.059; P=0.002) and D-dimer level 1 day after surgery (OR=1.065, 95% CI: 1.030–1.102; P<0.001) were independent risk factors for DVT during hospitalization. Similarly, age (OR=1.045, 95% CI: 1.021–1.070; P<0.001) and D-dimer level 1 day after surgery (OR=1.048, 95% CI: 1.014–1.083; P=0.006) were independent risk factors for DVT 1 month after surgery. During hospitalization and 1 month after surgery, 15.79% and 12.35% of patients had double lower limb thrombosis and 4.04% and 6.48% of patients had DVT in the uninjured limb only, respectively. Conclusion. The actual incidence of DVT in the uninjured limb in patients with lower extremity fractures cannot be ignored despite the use of anticoagulants for prevention or treatment during hospitalization. We should also be aware of DVT in the uninjured limb while focusing on DVT in the injured limb.

The Diagnosis of Established Deep Vein Thrombosis

1979 ◽  
Author(s):  
R. Hull ◽  
J. Hirsh
Keyword(s):  
Deep Vein Thrombosis ◽  
Doppler Ultrasonography ◽  
Clinical Symptoms ◽  
Reference Method ◽  
Impedance Plethysmography ◽  
Vein Thrombosis ◽  
Non Invasive ◽  
Patient Morbidity ◽  
Low Sensitivity ◽  
Deep Vein

It is now generally accepted that the clinical diagnosis of deep venous thrombosis (DVT) is inaccurate both because of low sensitivity and specificity. Because more than 50% of symptomatic patients fail to show thrombi on venography, anticoagulant therapy on the basis of clinical symptoms of DVT is not acceptable. Venography has been the standard reference method for the diagnosis of DVT but is invasive and consequently associated with patient morbidity. Impedance plethysmography (IPG) and Doppler ultrasonography (Doppler) are both non-invasive and, in patients with clinically suspected DVT, are sensitive and specific tests for proximal DVT. Both tests are relatively insensitive to calf DVT. IPG has the advantage of being an objective technique whereas Doppler is subjective and its accuracy may suffer in inexperienced hands. 125I fibrinogen leg scanning (leg scanning) is an inappropriate test when used alone in patients with clinically suspected DVT as it is insensitive in the upper thigh, may be negative in 30% of patients with established DVT and may take up to 72 hours to become positive. The combination, however, of IPG and leg scanning provides an accurate approach for the detection of both proximal and calf DVT in patients with established DVT. This approach is not associated with patient morbidity and offers the clinician an alternative to venography.

scholarly journals Doppler ultrasonography versus venography in the detection of deep vein thrombosis in patients with pulmonary embolism

2007 ◽  
Vol 24 (2) ◽  
pp. 223-223 ◽  
Author(s):  
Ömer Özbudak ◽  
Ismail Eroğulları ◽  
Candan Öğüş ◽  
Aykut Çilli ◽  
Mehtap Türkay ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Deep Vein Thrombosis ◽  
Doppler Ultrasonography ◽  
Vein Thrombosis ◽  
Deep Vein
Sign in / Sign up

Export Citation Format

Share Document