Mihaela Ioana Maris, Mihaela Flavia Avram and Danina Mirela Muntean
Compared to deep vein thrombosis in the lower limbs, upper extremity deep vein thrombosis is uncommon and therefore much less explored or even neglected.
We present the case of a 40-year-old female working in the bakery industry, who was admitted for acute onset of upper limb oedema accompanied by pain and functional impairment, affirmative secondary to the sustained and intense effort of the dominant arm. The diagnosis was confirmed by Duplex Ultraso nography on the eighth day after the onset of symptoms. Since clinical examinations and laboratory work excluded any cause of secondary thrombosis, the diagnosis of primary thrombosis was established. The only possible cause of this episode was linked to the woman’s work. The trigger for the thrombotic event was represented most likely by strenuous physical activity with temporary obstruction of the thoracic outlet in the work field. Under anticoagulant treatment, the signs and symptoms gradually resolved. Unfortunately, at the one-year follow-up exam, the patient was diagnosed with post-thrombotic syndrome of the right, dominant arm.
Mihaela Ioana Maris, Sorin Ursoniu, Danina Mirela Muntean, Sorin Olariu and Daniela Radu
The purpose of this paper was to compare the costs of three noninvasive diagnostic investigations as the initial tests in peripheral artery disease management in Romania.
A cost analysis of three imaging diagnostic tests was performed at the university hospital in Timișoara, Romania. The tests were as follows: arterial Duplex Ultrasound Scanning, Computed Tomography Angiography, and Contrast-enhanced Magnetic Resonance Angiography. The evaluation of the diagnostic test performance was performed together with the calculation of the real costs of each investigation. Finally, an economic evaluation of different diagnostic tests was done.
A number of 46 patients (36 male and 10 female) were included in the study. The selected patients have been subjected to a total number of 61 diagnostic tests prior to the therapeutic decision. Both in terms of sensitivity and specificity, Duplex Ultrasound Scanning and Computed Tomography Angiography showed little difference in our study. The cost analysis results showed a net economic advantage if Duplex Ultrasound Scanning is applied as a diagnostic method under conditions of obtaining a similar effect.
In conclusion, Duplex Ultrasound Scanning is accurate, safe, and cost-effective in designing the final therapeutic plan in peripheral artery disease (PAD), especially in the femoropopliteal segment.