Hip Pelvis.  2014 Jun;26(2):124-127. 10.5371/hp.2014.26.2.124.

Deep Vein Thrombosis in a Patient with Polycythemia Vera Who Underwent Hip Surgery: A Case Report

• Lee YS
• Seo BH
• Lee SW
• Kim SH
• Ahn BK

• KMID: 2054174
• DOI: http://doi.org/10.5371/hp.2014.26.2.124

Abstract

A 68-year-old woman who suffered from polycythemia vera presented at our clinic with the chief complaints of pain, swelling, and a warm sensation in her left thigh. She had undergone a left bipolar hemiarthroplasty following a hip fracture 24 days prior to this presentation. Her erythrocyte sedimentation rate and C-reactive protein (CRP) levels were elevated. In addition, a postoperative infection was suspected in the 3-phase bone scan; therefore, she received intravenous antibiotic therapy. This approach proved to be ineffective and she was subsequently diagnosed with a deep vein thrombosis via color Doppler ultrasonography. It is interesting to note that a deep vein thrombosis can present with symptoms similar to those of a postoperative infection. Furthermore, an elevated CRP level is frequently observed in patients suffering from polycythemia vera. Therefore, the two conditions, which require completely different treatments, can be confused. We report on this case with a review of the relevant literature.

Keyword

Polycythemia vera; Deep vein thrombosis; Postoperative infection

MeSH Terms

Aged
Blood Sedimentation
C-Reactive Protein
Female
Hemiarthroplasty
Hip*
Humans
Polycythemia Vera*
Sensation
Thigh
Ultrasonography, Doppler, Color
Venous Thrombosis*
C-Reactive Protein

Figure

• 

  Fig. 1 Two plain radiographs showing no significant differences between the immediate postoperative radiograph (A) and the radiograph taken at the initial postoperative visit (B).

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  Fig. 2 A 3-phase bone scan showing diffuse mild-to-moderate increased uptake in the periprosthetic region and left buttock in the dynamicand pool phases (A, B) and no remarkable increased uptake in the delayed phases (C). ANT: anterior view, POST: posterior view, RT.LAT: right lateral view, LT.LAT: left lateral view.

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  Fig. 3 Color Doppler ultrasonography shows the deep vein thrombosis in the left superficial femoral vein (A) and the common femoral vein (B).

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