Paget-Schroetter Syndrome
This is a potentially dangerous and fatal complication involving thrombosis of the upper extremity as a result of hypertrophied muscles. Symptoms typically develop in a patient’s dominant arm following strenuous activities including rowing, weight lifting, wrestling, and pitching in baseball. The vigorous activity leads to microtrauma to the vascular intima, and initiates a coagulation cascade. This blood clotting ultimately results in the deep vein thrombosis. If an examiner suspects the presence of this condition, they should immediately contact a physician.
Signs in common with thoracic outlet syndrome
(Vijaysadan et. al., 2005 & Watson et. al., 2009)
Signs in common with thoracic outlet syndrome
- Tightness or “heaviness” in affected biceps muscle, shoulder, neck, upper back, and axilla
- Positive provocation thoracic outlet syndrome provocation tests
- Swelling and redness in the hand, upper arm, and posterolateral shoulder with increased tissue temperature over the shoulder
- Painful limitation of active internal and external humeral rotation
- Positive rotator cuff tests
- Ecchymosis and non-edematous swelling of the shoulder, arm, and hand
- Functional impairment
- Discoloration and mottled skin
- Distention of the cutaneous veins of the involved upper extremity
- Neer and Hawkins impingement tests (rules in rotator cuff pathology)
- Jobe (supraspinatus) test
- Speed’s test (rules in biceps tendon pathology)
- External rotation test (rules in infraspinatus pathology)
- Lift off and press belly test (rules in subscapularis pathology)
(Vijaysadan et. al., 2005 & Watson et. al., 2009)