Arm Pain In A Healthy Weight Lifter - Page #4

Working Diagnosis:
Paget Schrotter syndrome Deep venous thrombosis of upper extremity)

He was started on low molecular weight heparin (LMWH) 100mg twice a day for a week and subsequently put on warfarin for six months with dosage adjustments as necessary.

Repeat venous doppler ultrasound of the right upper extremity after six months showed no evidence of thrombosis (Photo 2).
He returned to his regular activity of weight lifting after treatment without problems.

Author's Comments:
In an athlete or adult with history of extreme weight lifting and arm swelling there should be a high suspicion for upper extremity deep venous thrombosis to prompt venous duplex scan.
The main stay of treatment for upper extremity deep vein thrombosis remains anticoagulation with low-molecular weight heparin and vitamin K antagonists, despite reported benefits to surgical evacuation of thrombus.

Editor's Comments:
Another good example of vascular disorders for which the sports medicine physician should be ready. Have seen several in the past 10 years - this is a classic case not to be missed!

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