Tromboflebite plantar: achados em ressonância magnética

Abstract

The authors declare that there was no conflict of interest in conducting this work ABSTRACTObjective: Demonstrate the magnetic resonance imaging (MRI) findings in plantar thrombophlebitis. Methods: Retrospective review of twenty patients with pain in the plantar region of the foot, in which the MRI findings indicated plantar thrombophlebitis. Results: A total of fourteen men and six women, mean age 46.7 years were evaluated. Eight of these patients also underwent Doppler ultrasonography, which confirmed the thrombophlebitis. The magnetic resonance images were evaluated in consensus by two radiologists with experience in musculoskeletal radiology (more than 10 years each), showing perivascular edema in all twenty patients (100%) and muscle edema in nineteen of the twenty patients (95%). All twenty patients had intraluminal intermediate signal intensity on T2-weighted (100%) and venous ectasia was present in seventeen of the twenty cases (85%). Collateral veins were visualized in one of the twenty patients (5%). All fourteen cases (100%), in which intravenous contrast was administered, showed perivenular tissues enhancement and intraluminal filling defect. Venous ectasia, loss of compressibility and no flow on Doppler ultrasound were also observed in all eight cases examined by the method. Conclusion: MRI is a sensitive in the evaluation of plant thrombophlebitis in patients with plantar foot pain.

Plantar vein thrombosis: a rare differential diagnosis in patients with plantar pain

“…Generally, the lateral plantar vein is most affected (in 96% of cases), followed by the middle plantar vein (in 41%) ( 3 ) . Several causal factors are speculated, among them traumas ( 4 , 5 ) , paraneoplastic syndromes ( 6 , 7 ) , postoperative conditions ( 4 , 7 ) , thrombophilias ( 2 , 6 ) , use of contraceptive drugs ( 2 , 4 ) , immobilization ( 5 , 6 ) and HIV infection ( 7 ) . However, most cases are classified as being idiopathic ( 2 ) .…”

“…Ultrasonography is considered to be the main imaging method for the diagnosis of PVT ( 1 , 3 ) , demonstrating hypoechoic venous content ( 2 , 6 ) associated with ectasia ( 2 , 5 , 6 ) , loss of vascular compressibility ( 2 , 4 ) and absence of flow at Doppler study ( 2 , 6 ) . However, plantar veins are neglected at routine examinations ( 1 , 2 , 4 ) , which may explain the low rate of diagnosis of the disease.…”

“…Main findings include characterization of intraluminal filling defect in plantar veins ( 2 , 4 , 6 ) in association with edema ( 5 , 6 ) and perivenular enhancement ( 5 ) . Such findings were observed in 100% of cases in one of the greatest studies approaching the theme ( 5 ) . On the other hand, only in 2008 the first case of PVT diagnosed at MRI was described ( 9 ) .…”

“…Amongst the differential diagnosis of PVT, plantar fasciitis ( 2 , 4 , 5 ) , tendinous involvement ( 3 , 5 ) , bursitis ( 5 ) , Morton's neuroma ( 4 , 5 ) , stress fractures ( 2 , 4 , 5 ) , sesamoiditis ( 5 ) and ganglion cysts ( 5 ) . No description of death associated with PVT is found in the literature.…”