Isolated Plantar Vein Thrombosis Resembling a Corn with a Bruise

Plantar Vein Thrombosis in the Medial Branch of the Posterior Tibial Vein: A Case Report

Plantar vein thrombosis (PVT) is an atypical cause of plantar heel pain and is seldom reported in the literature. We present a unique, rare case report of a patient exhibiting plantar heel and medial arch pain caused by thrombosis in the plantar medial branch of the posterior tibial vein. The diagnosis was made by means of magnetic resonance imaging, showing lobulated hypointensity in the medial plantar vein, consistent with a PVT. In this article, we provide an overview of the clinical signs of PVT, which is most commonly plantar heel pain. Furthermore, we discuss ultrasound and magnetic resonance imaging as diagnostic modalities, and conservative treatment options, including anti-inflammatory medications, anticoagulation therapy, and compression therapy. As with other types of venous thromboembolism, this condition must also be diagnosed without delay to avoid potential complications.

Ultrasound findings in subcutaneous plantar vein thrombosis: retrospective analysis of seven patients

BACKGROUND

Several disorders may result in forefoot pain. An uncommon cause of forefoot pain is subcutaneous plantar veins thrombosis (SCPVT) involving veins superficial to the plantar fascia.

PURPOSE

To describe the ultrasound (US) appearance of SCPVT, which has been described only once in the radiological literature.

MATERIAL AND METHODS

We performed a retrospective search of our PACS system from 2016 to 2020 to collect all cases of US-diagnosed SCPVT. We collected data on seven patients. Two radiologists analyzed the US images retrieved. All US examinations were performed with a multifrequency linear probe (frequencies in the range of 5-17 MHz).

RESULTS

A localized plantar nodule was palpable in 86% of patients. The subcutaneous thrombosed vein appeared in all patients as a round or ovoid nodule located in the subcutaneous tissues that corresponded in four patients (4/5, 80%) to the painful palpable nodule. The size was in the range of 4-7 mm (mean = 5.4 mm). The thrombosed vein presented a connection with adjacent patent veins, appeared enlarged, and almost filled with hypo-isoechoic material, and in two patients (2/7, 29%), a thin peripheral fluid component surrounding the thrombus was detectable. Continuous scanning demonstrated slow blood movements inside the peripheral component due to blood circulation. Failure to compress the lumen of the thrombosed vein during the real-time US was evident in all patients.

CONCLUSION

SCPVT is a rare or underreported condition. Sonologists must know the US appearance of SCPVT to exclude other conditions and avoid unnecessary invasive studies.