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. 2020 Apr;64(1):76-81.

Superficial venous thrombosis of the upper limb presenting to a chiropractic clinic: a case report

Paul Mastragostino  1 , Chadwick Chung  2
Affiliations

Superficial venous thrombosis of the upper limb presenting to a chiropractic clinic: a case report

Paul Mastragostino et al. J Can Chiropr Assoc. 2020 Apr.

Abstract
in English, French

Objective: To present the clinical case of a patient with an upper extremity superficial venous thrombosis (SVT), and to highlight the importance for clinicians working in musculoskeletal care settings, to considered non-musculoskeletal causes for their patients' presentations.

Clinical features: A 31-year-old male presented to an academic chiropractic clinic with progressive left sided tension over the medial arm, extending to the anterior aspect of his proximal forearm.

Intervention and outcome: The patient was initially diagnosed with possible biceps/brachialis muscular strain and peripheral entrapment of the median nerve. A course of treatment involving soft tissue therapy was initiated. Unfortunately, the patient's symptoms worsened, and on further evaluation, near full occlusion and phlebitis of the left cephalic vein was discovered. Symptoms dissipated over the next few days with conservative medicinal efforts.

Summary: Although not often viewed as a serious condition, or factored in the differential diagnoses of musculoskeletal practitioners, to not consider SVT as a cause of a patient's symptoms may lead to a protracted clinical course and increased discomfort for the patient, and in rare cases, more serious consequences.

Objectif: Présenter le cas d’un patient ayant une thrombose veineuse superficielle (TVS) du membre supérieur et souligner l’importance pour le clinicien dans un établissement de traitement de troubles musculosquelettiques de prendre en compte les causes qui ne sont pas d’origine musculosquelettique dans l’étude du tableau clinique du patient.

Caractéristiques cliniques: Un homme de 31 ans s’est présenté à une clinique chiropratique universitaire en raison d’une tension progressive ressentie à partir de la partie médiane du bras gauche jusqu’à la face antérieure de l’avant-bras proximal.

Intervention et résultat: On a d’abord évoqué la possibilité d’une foulure du biceps ou du muscle brachial antérieur et d’un englobement périphérique du nerf médian. Une thérapie des tissus mous a été amorcée. Mais malheureusement, les symptômes du patient se sont aggravés et, après une évaluation plus approfondie, on a découvert une occlusion presque complète de la veine céphalique gauche et une phlébite. Les symptômes se sont dissipés au cours des jours qui ont suivi le début d’un traitement conservateur par des médicaments.

Résumé: La TVS n’est pas souvent considérée comme une affection grave et n’est pas prise en compte dans les diagnostics différentiels posés par les praticiens de l’appareil locomoteur. En ne la considérant pas comme une possible cause des symptômes d’un patient, on risque de prolonger les interventions et d’aggraver la gêne du patient, et dans de rares cas, de causer des conséquences plus graves.

Keywords: chiropractic; diagnosis; management; superficial venous thrombosis; upper limb.

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Conflict of interest statement

The authors have no disclaimers, competing interests, or sources of support or funding to report in the preparation of this manuscript.

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