title: Diagnosis of a rare source of upper extremity symptoms in a healthy woman after weight lifting.
abstract: METHODS
  Resident's case problem.
  
  
  BACKGROUND
  The popularity of weight training has increased dramatically during the past 20 years. With the increase in popularity of weight training, the rate of injury has also increased dramatically. The types of injuries range from benign to life threatening.
  
  
  METHODS
  The patient was a 21-year-old woman originally referred for pelvic pain who presented with new complaints of right upper extremity swelling, discomfort, and cyanosis after recently beginning a comprehensive weight-lifting program. Additional signs, including paresthesias decreased pulses, and venous distension, warranted a timely referral by the physical therapist bavk to the referring physician.
  
  
  CONCLUSIONS
  The primary injury in this case report was hypothesized to have been induced by the recent start of a weight-lifting program, with no other significant contributing risk factors. A comprehensive examination by the physical therapist revealed clinical signs of an upper extremity deep vein thrombosis, leading to a same-day referral back to the referring physician. Further research, resulting in a clinical decision rule for upper extremity deep vein thrombosis or estimates of diagnostic accuracy of clinical signs and symptoms, would improve the diagnostic process.
authors.affiliation: Department of Community and Family Medicine, University, Duke University Medical Center 3907, Durham, NC 27710, USA. eric.hegedus@duke.edu
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Hegedus
authors.forename: Lesley
authors.initials: L
authors.lastname: Cooper
authors.forename: Chad
authors.initials: C
authors.lastname: Cook
mesh_terms: D000328:Adult; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D010292:Paresthesia / Q000209:etiology; D011655:Pulmonary Embolism / Q000175:diagnosis; D011674:Pulse; D020246:Venous Thrombosis / Q000150:complications / Q000175:diagnosis* / Q000209:etiology; D014891:Weight Lifting