Paget-Schroetter Syndrome in a Patient With Posterior Shoulder Subluxation: A Case Report

Author:

Röthlisberger David1ORCID,Rashid Mustafa S.23,Ruijs Peter4,Zumstein Matthias A.125

Affiliation:

1. Shoulder, Elbow and Orthopaedic Sports Medicine, Bern, Switzerland;

2. Shoulder, Elbow and Orthopaedic Sports Medicine, Sonnenhof Orthopaedics, Bern, Switzerland;

3. Department of Orthopaedic Surgery, University of Calgary, Calgary, AB, Canada;

4. Department of Radiology, Sonnenhof Hospital, Bern, Switzerland; and

5. Shoulder and Elbow, Department of Orthopaedic Surgery and Traumatology, Inselspital, Bern University Hospital, Bern, Switzerland.

Abstract

Abstract: Paget-Schroetter syndrome describes a primary thrombosis of the subclavian vein induced by effort. In most cases, the clinical presentation includes painful swelling, discoloration, and visible collateral circulation in the arm. Paget-Schroetter syndrome is treated with anticoagulation, rest, and physical therapy. In certain cases, invasive treatment such as thrombolysis and decompression surgery (first rib resection) may be necessary. We present the case of a 28-year-old healthy male patient with effort-induced deep vein thrombosis of the upper extremity after posterior shoulder subluxation. Anticoagulation, rest, and physical therapy were used to treat the patient, who became asymptomatic and was able to resume normal activities without restriction. To our knowledge, this is the first case of effort-induced upper extremity deep vein thrombosis after posterior shoulder subluxation. Paget-Schroetter syndrome is rare diagnosis that requires vigilance during musculoskeletal assessment for shoulder pain and swelling. The early detection, radiological confirmation, and prompt initiation of treatment are essential to successful management of Paget-Schroetter syndrome. The impact of associated posterior shoulder subluxation remains unclear.

Publisher

Ovid Technologies (Wolters Kluwer Health)

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