Swellengrebel Herman Jan Christiaan, Backus Thijs, Zijta Frank Marinus, van der Zwaal Peer
Sports and Exercise Medicine, Haaglanden Medisch Centrum Antoniushove, Leidschendam, The Netherlands
General Practice, SHG Gezondheidscentrum De Koning, The Hague, The Netherlands.
BMJ Case Rep. 2019 Nov 26;12(11):e230054. doi: 10.1136/bcr-2019-230054.
A 61-year-old mountain hiker presented with acute pain of the medial-plantar aspect of the right foot. As the location, intensity and acute onset of the pain were atypical for fasciitis plantaris, an ultrasound was performed. This demonstrated a segmental plantar vein thrombosis (PVT), which was confirmed on consequent MRI. Patient was a non-smoker, without a medical or family history of coagulopathies. Four months previously, he suffered from metatarsalgia of the left, thus contralateral, foot, which prompted treatment with bilateral orthoses. In addition to metatarsal padding, medial-arch support was prescribed due to the presence of flexible flatfeet. Following internal medicine consultation, treatment consisted of discontinuing the use of orthoses, rest and non-steroidal anti-inflammatory drugs (NSAIDs). At 2-week follow-up, the patient was pain-free. In this case report, PVT, a rare cause for plantar heel pain, is discussed. In addition, a summary of the diagnosis and treatment of PVT is outlined.
一名61岁的登山者因右脚足底内侧急性疼痛前来就诊。鉴于疼痛的部位、强度和急性发作情况不符合足底筋膜炎的典型表现，遂进行了超声检查。检查显示为节段性足底静脉血栓形成（PVT），后续的MRI检查证实了这一结果。患者不吸烟，无血液系统疾病的个人史或家族史。四个月前，他左侧（即对侧）足部患有跖痛症，因此接受了双侧矫形器治疗。除了跖骨垫外，由于存在柔韧性扁平足，还开具了内侧足弓支撑。在内科会诊后，治疗措施包括停用矫形器、休息以及使用非甾体抗炎药（NSAIDs）。在2周的随访中，患者疼痛消失。在本病例报告中，讨论了PVT这种导致足底足跟疼痛的罕见原因。此外，还概述了PVT的诊断和治疗要点。
