Learning objectives
LEARNING OBJECTIVES
This study aims to illustrate the cases of venous thrombosis diagnosed onmagnetic ressonance imaging (MRI) in patients with initial suspicion of a musculoskeletal pain,
focusin in:
1.
llustrate the main imaging findings of venous thrombosis in MRI.
2.Illustrate the key tips to differentiate a musculoskeletal pathology from a venous thrombosis.
3.
Correlate MRI and Doppler ultrasound to show how this correlation may help reaching the correct diagnosis.
Background
Patients with venous thrombosis may present with non-specific pain of an apparent musculoskeletal nature.This clinical symptoms may delay the accurate diagnosis of a venous thrombosis,
that may frequently be mistaken for a muscle strain or an articular derangement.
Venous thrombosis is often diagnosed by Doppler ultrasound,
in a classic clinical context of swelling,
tenderness and increased limb temperature.
In this scenario such diagnosis is expected and does not bring difficulties.
However,
when patients with venous thrombosis present with non-specific pain andwhen there is alow pre-test...
Imaging findings OR Procedure Details
PROCEDURE DETAILS
The imaging studies of patients with venous thrombosis first diagnosed on the basis of MRI findings were reviewed.
• All the selected patients had an initial clinical suspicion in the scope of musculoskeletal injuries,
and deep venous thrombosis was unsuspected on clinical grounds.
• The clinical hypothesis before the MRI examination were plenty: gastrocnemius strain,
morton’s neuroma,
plantar fasciitis,
tendinopathy etc,
which explains the choice for a MRI over ultrasound as the first diagnostic modality.
IMAGING FINDINGS
The main findings of venous thrombosis...
Conclusion
Venous thrombosis is an important and frequent diagnosisand itsclinical symptoms may mimic musculoskeletal pain,
making the recognition of this entity a key differentiator for painful conditions in the MRI of the musculoskeletal system.
When facing a patient with a clinical history of possible muscle strain and marked muscular edema,
although the tendency is to favor traumatic etiologies,one must be aware thattheidentification of a branching enhancingtubular structure or a vessel ectasia within the edematous muscles is suggestiveof a venous thrombosis,
and this diagnosis should not be...
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