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Paget-Schroetter Syndrome, Sports Medicine

Misha Khalighi, MD and Chris Koutures, MD, FAAP Reviewed 04/2019
 


BASICS

DESCRIPTION

  • Paget-Schroetter syndrome (PSS) is venous thrombosis resulting from chronic compression of the subclavian vein 1. Compression in an anatomically normal extremity occurs in extremes o...

DIAGNOSIS

HISTORY

  • Abrupt painful and swollen upper extremity with blue hue in a young athletic male 2

  • Symptoms typically occur within 24 hr of vigorous or heavy upper extremity activity 1.

PHYSICAL EXAM

  • V...

TREATMENT

GENERAL MEASURES

  • Anticoagulation, symptomatic treatment, and relief of extrinsic compression 2

  • Symptom relief requires pain control and compression 2.

  • Catheter-directed thrombolysis provides sh...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • After surgical decompression, patients discharged on therapeutic anticoagulation, typically weight-based low-molecular-weight heparin 2.

  • Follow-up venography shoul...

REFERENCES

1
Mall NA, Van Thiel GS, Heard WM, et al. Paget-Schroetter syndrome: a review of effort thrombosis of the upper extremity from a sports medicine perspective. Sports Health.  2013;5(4):3...

CLINICAL PEARLS

  • PSS is venous thrombosis of the subclavian/axillary vein caused by compression of the venous thoracic outlet in conjunction with chronic injury to the vein by repeated overhead arm act...

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