Dados do Trabalho

Título

PLANTAR VEIN THROMBOSIS – A DIFFICULT AND HARDLY EVER REMEMBERED DIAGNOSIS

Introdução

Plantar vein thrombosis is a venous disorder affecting the deep plantar veins, that can manifest with non-specific pain, plantar foot pain, local swelling, and a heavy sensation in the affected foot. Furthermore, the plantar veins are not routinely assessed in current compression sonography protocols of deep venous thrombosis, what makes plantar vein thrombosis an underdiagnosed disease.
The plantar digital veins originate from the plexus on the plantar surface of the digits, joining to form the metatarsal veins, located in the metatarsal spaces, which then form the deep plantar venous arch. They give origin to the medial and lateral veins, accompanying the lateral and medial plantar artery., which, after emitting the great and small saphenous vein, unite behind the medial malleolus to give origin to the posterior tibial veins. The lateral plantar veins are more affected by
thrombosis than the medial plantar veins are.

Descrição

Although plantar vein thrombosis is a rare cause of foot pain, it can be included as a differential diagnosis. In this serie of cases, we approach several cases in order to add to literature, therefore the diagnosis of plantar venous thrombosis can be performed more confidently, excluding possible differential diagnoses.

Discussão

Plantar vein thrombosis is relatively rare and should be considered in the differential diagnostic of plantar heel pain, especially when the patient reports spontaneous foot pain, characterized as "heavy" sensation. The plantar veins are usually overlooked in routine sonography protocols of deep venous thrombosis assessment, being considered an under-diagnosed condition and frequently – and unfortunately – missed. Diagnosis can easily be made through US and MRI, therefore, knowledge of the plantar venous anatomy and the active search for imaging findings are of major importance to carry out an early and assertive diagnosis. Therefore, the treatment can be promptly carried out aiming at the best prognosis of the patient.

Palavras Chave

Plantar Vein thrombosis; MR; Anatomy; Ultrasound

Área

Musculoesquelético (incluindo USG)