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Abstract
Although Baker's cysts may mimic deep vein thrombosis, it is unusual for the two conditions to coexist in the same patient. The authors report a case of a fifty-eight-year-old man who had repeated episodes of deep venous thrombosis in spite of anticoagulation and arthroscopic joint debridement. Ultimately, total knee arthroplasty corrected the problem so that the patient has had no further recurrence of venous thrombosis upon follow-up. A brief discussion of these two conditions follows the case report.
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Affiliation(s)
| | - James G. Howe
- Division of Vascular and Transplant Surgery and the Department of Orthopedics and Rehabilitation, University of Vermont, Burlington, Vermont
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Xiao L, Ling F, Tan L, Li H, Hu C, Luo Y, Tang D, Liu F, Kanwar YS, Sun L. Spontaneous calf hematoma in a patient with diabetic nephropathy receiving maintenance hemodialysis: A case report and review of the literature. Hemodial Int 2014; 19:E49-53. [PMID: 25404456 DOI: 10.1111/hdi.12246] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
We report the outcome of a 52-year-old patient with diabetic nephropathy and receiving maintenance hemodialysis (HD) using low molecular weight heparin (LMWH) as an anticoagulant for 2 years. He presented right lower limb pain accompanied with difficulty in walking for 2 months, and had no history of bleeding tendency or trauma. Physical examination revealed marked swelling and tenderness on his right lower limb. By ultrasound and magnetic resonance imaging (MRI) diagnoses, the calf hematoma was diagnosed and identified with venous thrombosis. Following treatment with heparin-free HD, the swelling regressed and pain subsided, and a follow-up MRI showed complete dissolution of hematoma. However, similar symptoms recurred in the right upper limb after 2 months without any predisposition, he was just placed on HD with LMWH, and symptoms regressed following the aforementioned therapy. This suggests that HD patients, especially with diabetic nephropathy having extremity hematoma, should be watched for the development of spontaneous hemorrhage that can be differentially diagnosed by imaging tests, such as MRI, and can be effectively treated with heparin-free HD.
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Affiliation(s)
- Li Xiao
- Department of Nephrology, Central South University, Changsha, Hunan, China
| | - Fengxia Ling
- Department of Nephrology, Central South University, Changsha, Hunan, China
| | - Lihua Tan
- Radiology Department Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Huabing Li
- Radiology Department Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Chun Hu
- Department of Nephrology, Central South University, Changsha, Hunan, China
| | - Ying Luo
- Department of Nephrology, Central South University, Changsha, Hunan, China
| | - Dang Tang
- Department of Nephrology, Central South University, Changsha, Hunan, China
| | - Fuyou Liu
- Department of Nephrology, Central South University, Changsha, Hunan, China
| | - Yashpal S Kanwar
- Departments of Pathology and Medicine, Northwestern University, Chicago, Illinois, USA
| | - Lin Sun
- Department of Nephrology, Central South University, Changsha, Hunan, China
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Aronen HJ, Svedström E, Yrjänä J, Bondestam S. Compression sonography in the diagnosis of deep venous thrombosis of the leg. Ann Med 1994; 26:377-80. [PMID: 7826599 DOI: 10.3109/07853899409148354] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
The value of compression sonography was assessed to reduce the number of phlebographies otherwise necessary when deep venous thrombosis (DVT) is suspected among hospital patients. Compression sonography was used to study 119 prospective hospital patients who were suspected of having DVT of the lower extremity. The results were compared to those by phlebography. There were 44 DVTs detected by phlebography; ten of these were located only in the calf, below the knee. Of the remaining 34 femoropopliteal DVTs 33 were detected by the compression sonography technique. It is concluded that the use of compression sonography for primary investigation of suspected DVT reduces the number of patients who require phlebography to those whose results by compression sonography are negative. In our study, this would have represented a decrease of 28%, corresponding to a reduction of the total diagnostic costs by 10%.
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Affiliation(s)
- H J Aronen
- Helsinki University Central Hospital, Department of Radiology, Finland
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