How Point-of-Care Ultrasound Led to a Diagnosis of May-Thurner Syndrome

Daniel L Belkin; Mitchell D Belkin; Maedeh Ashrafi; Charan Vegivinti; Yung-Hsien Wang; Leonidas Palaiodimos

doi:10.24908/pocus.v6i2.15105

How Point-of-Care Ultrasound Led to a Diagnosis of May-Thurner Syndrome

POCUS J. 2021 Nov 23;6(2):76-79. doi: 10.24908/pocus.v6i2.15105. eCollection 2021.

Authors

Daniel L Belkin¹, Mitchell D Belkin², Maedeh Ashrafi^{1

3}, Charan Vegivinti^{1

3}, Yung-Hsien Wang^{1

3}, Leonidas Palaiodimos^{1

3}

Affiliations

¹ Albert Einstein College of Medicine Bronx, New York, 10461.
² University of Maryland School of Medicine Baltimore, Maryland, 21201.
³ Department of Medicine, Jacobi Medical Center, NYC H+H Bronx, New York, 10461.

Abstract

A 65-year-old man with a history of a left-sided inguinal hernia presented with three days of left-sided groin pain worsened with exertion and fatigue. The patient was afebrile but tachycardic, and physical examination revealed a tender, erythematous immobile bulge in his left groin. Laboratory studies revealed leukocytosis. Lymphadenopathy secondary to infectious or inflammatory etiology was suspected. However, point-of-care ultrasound (POCUS) identified extensive deep vein thrombosis (DVT) of the lower left limb. Follow-up imaging revealed this to be secondary to May-Thurner syndrome, a mechanical compression of an iliocaval vein against the lumbar vertebrae by a common iliac artery. This report demonstrates how POCUS can be used to identify lower extremity DVT, thereby expediting diagnosis and treatment and potentially preventing complications.

Keywords: DVT; May- Thurner syndrome; POCUS; Vascular; deep vein thrombosis; point-of-care ultrasound; thrombectomy.

Publication types

Case Reports