PMC5109250_01
There was a difference in circumference of the left arm (50.5 cm) (A) and forearm (36 cm) (B) when compared to the right arm (38 cm) (C) and forearm (27 cm) (D).
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On exam, no color change but a significant difference in circumference of the left arm when compared to the right arm was observed (Fig. 1).
Ultrasound images of brachial vein thrombosis of the left arm. a. Coronal view. b. Sagittal view of thrombosed brachial extendig to axillary vein.
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Duplex ultrasonography of the left arm demonstrated a large, nearly occlusive thrombus in the left axillary vein extending to the left brachial vein (Fig. 2). D-dimer level was within normal limits and there was no abnormality in thrombophilia screening including factor V Leiden mutation, prothrombin mutation, antithrombin III, MTHFR mutation, protein