Deep venous thrombosis caused by femoral exostosis.
OBJECTIVE
To present the first case of deep venous thrombosis caused by femoral exostosis reported in Australia.


METHODS
An 11-year-old prepubertal Caucasian girl had a two-year history of a posterior femoral exostosis. She then presented with a deep venous thrombosis 24 hours after riding a horse for the first time. The deep venous thrombosis was diagnosed by Doppler ultrasound, which showed an intimate relationship between the femoral exostosis and the femoral vein. Coagulation abnormalities were excluded.


RESULTS
The patient was given anticoagulation therapy with heparin intravenously and warfarin orally. The popliteal vein recanalised within two days. The exostosis was excised 10 weeks after initial presentation, with warfarin being continued for four weeks postoperatively. Two months after excision the patient was symptom free.


CONCLUSIONS
It is possible for venous compression by an exostosis to result in thrombosis in a patient with no underlying coagulation abnormality. Palpation and plain radiography of the region will demonstrate the exostosis; ultrasound is the next investigation of choice.
Keeling
S L
SL
Royal Children's Hospital, Parkville, VIC.
Numa
A
A
Wilde
P
P
Davis
J
J
McLellan
J
J
D000925:Anticoagulants / Q000627:therapeutic use; D002648:Child; D003251:Constriction, Pathologic / Q000150:complications / Q000000981:diagnostic imaging / Q000209:etiology; D005096:Exostoses / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D005260:Female; D005268:Femoral Vein; D005269:Femur / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D013924:Thrombophlebitis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology*; D014463:Ultrasonography
D000925:Anticoagulants