Paget-Schroetter disease physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Anahita Deylamsalehi, M.D.[2]

Overview

Common physical examination findings of Paget-Schroetter disease include edema, tenderness, and dilated veins over the involved upper limb.

Physical Examination

Appearance of the Patient

• Patients with Paget-Schroetter disease usually appear normal.

Vital Signs

• No significant changes in vital signs can be noted.

Skin

• Cyanosis
• blue discoloration

HEENT

• HEENT examination of patients with Paget-Schroetter disease is usually normal.

Neck

• Neck examination of patients with Paget-Schroetter disease is usually normal.

Lungs

• Pulmonary examination of patients with Paget-Schroetter disease is usually normal.

Heart

• Cardiovascular examination of patients with Paget-Schroetter disease is usually normal.

Abdomen

• Abdominal examination of patients with Paget-Schroetter disease is usually normal.

Back

• Back examination of patients with Paget-Schroetter disease is usually normal.

Genitourinary

• Genitourinary examination of patients with Paget-Schroetter disease is usually normal.

Neuromuscular

Neuromuscular examination of patients with Paget-Schroetter disease is usually normal.

Extremities

• Urschel’s sign : Visible and dilated veins on shoulder, upper extremity, base of neck and upper chest.
• Tenderness
• Tense upper limb
• Edema (increase in girth of affected arm compared to unaffected arm)
• Positive Roos test
• Palpation of thrombosed vein in the axilla.

Significant edema, blue discoloration, and dilatation of the superficial veins in the patient’s right upper limb, Case courtesy by Ebru Aytekin, MD

Evident superficial collateralization in the chest, shoulder and upper right limb. Case courtesy by Dra Julieta Rosana Crosta, MD.