Clinical Practice and Cases in Emergency Medicine (Aug 2020)

A Case Report on Paget-Schroetter Syndrome Presenting as Acute Localized Rhabdomyolysis

  • Jonathan B. Lee,
  • Ami Kurzweil,
  • Shadi Lahham

DOI
https://doi.org/10.5811/cpcem.2020.6.47335
Journal volume & issue
Vol. 4, no. 3

Abstract

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Introduction: The life- or limb-threatening differential diagnosis for upper extremity swelling can include deep vein thrombosis (DVT), infectious processes, and compartment syndrome. Chronic anatomic abnormalities such as axillary vein stenosis are rarely a consideration in the emergency department. Case Report: We present a 26-year-old female with history of Chiari type 1 malformation who presented with acute left arm swelling. Initial workup, including point-of-care ultrasound, revealed the presence of significant soft tissue swelling without evidence of DVT. Conclusion: Further workup revealed an early, localized rhabdomyolysis secondary to axillary vein stenosis or venous thoracic outlet syndrome, also known as Paget-Schroetter syndrome.