Age / Sex : 72 / F

Chief complaint : 열흘 전부터 무릎 부종, 통증으로 인근 병원에서 주사, 약물치료 받았으나 효과없고, 점점 악화됨.


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Courtesy : 채지원(Jee Won Chai), 서울특별시 보라매병원(SMG SNU Boramae Medical Center)

Deep Vein Thrombosis

Discussion

Deep venous thrombosis (DVT) is a major cause of morbidity and mortality all over the world. It commonly occurs in the lower extremity and is associated with life threatening complication of pulmonary embolism (PE) referred together as venous thrombo-embolism (VTE). Radiologists should be aware that DVT can contribute to knee swelling and pain.

Findings
1. Radiographs : osteoarthritis of the knee with diffuse soft tissue swelling, no visible periarticular osteopenia nor chondrocalcinosis
2. MR : pre-contrast T1WI shows intermediate to high SI in the distended popliteal vein which lacks contrast enhancement on enhanced T1 sag T1WI.
Prominent soft tissue edema around the knee joint and also in muscles at posterior knee, with contrast filling defect in the popliteal vein. Relatively minimal joint effusion and synovial enhancement.

References
1. Skeletal Radiol. 2006 Sep;35(9):659-64. Unsuspected lower extremity deep venous thrombosis simulating musculoskeletal pathology
2. Skeletal Radiol. 2022 Jul;51(7):1511-1516. Deep vein thrombosis in the thigh: MR imaging in two cases with atypical presentations