Traumatic deep vein thrombosis in a soccer player: A case study

Paul S Echlin¹ , Ross EG Upshur²^,3^,4 , Douglas B McKeag⁵ and Harsha P Jayatilake⁶

¹Providence Athletic Medicine, Providence Hospital and Medical Centers, 47601 Grand River Avenue, Suite 101, Novi Michigan, United States of America 48374

²Primary Care Research Unit, Department of Family and Community Medicine, Sunnybrook and Women's College Health Sciences Centre, 2075 Bayview Avenue, #E-349, Toronto, Ontario, Canada M4N 3M5

³Department of Family and Community Medicine, University of Toronto, 263 McCaul Street, Toronto, Ontario, Canada M5T 1W7

⁴Department of Public Health Sciences, University of Toronto, 12 Queen's Park Crescent W., Toronto, Ontario, Canada M5S 1A8

⁵Department of Family Medicine, Indiana University, Long Hospital, Second Floor. 1110 West Michigan Street, Indianapolis Indiana, United States of America 46202-5102

⁶Department of Family Medicine, Wayne State University, 15400 West McNichols, 2^ndFloor, Detroit, Michigan, United States of America 48235

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Thrombosis Journal 2004, 2:8doi:10.1186/1477-9560-2-8


Published:	14 October 2004

Abstract

A 42 year-old male former semi-professional soccer player sustained a right lower extremity popliteal contusion during a soccer game. He was clinically diagnosed with a possible traumatic deep vein thrombosis (DVT), and sent for confirmatory tests. A duplex doppler ultrasound was positive for DVT, and the patient was admitted to hospital for anticoagulation (unfractionated heparin, warfarin). Upon discharge from hospital the patient continued oral warfarin anticoagulation (six months), and the use of compression stockings (nine months). He followed up with his family doctor at regular intervals for serial coagulation measurements, and ultrasound examinations. The patient's only identified major thrombotic risk factor was the traumatic injury. One year after the initial deep vein thrombosis (DVT) the patient returned to contact sport, however he continued to have intermittent symptoms of right lower leg pain and right knee effusion.

Athletes can develop vascular injuries in a variety of contact and non-contact sports. Trauma is one of the most common causes of lower extremity deep vein thrombosis (DVT), however athletic injuries involving lower extremity traumatic DVT are seldom reported. This diagnosis and the associated risk factors must be considered during the initial physical examination. The primary method of radiological diagnosis of lower extremity DVT is a complete bilateral duplex sonography, which can be augmented by other methods such as evidence-based risk factor analysis. Antithrombotic medication is the current standard of treatment for DVT. Acute thrombolytic treatment has demonstrated an improved therapeutic efficacy, and a decrease in post-DVT symptoms.

There is a lack of scientific literature concerning the return to sport protocol following a DVT event. Athletic individuals who desire to return to sport after a DVT need to be fully informed about their treatment and risk of reoccurrence, so that appropriate decisions can be made.