{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T20:04:12Z","timestamp":1790021052151,"version":"4.0.1"},"reference-count":13,"publisher":"BMJ","issue":"4","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J R Army Med Corps"],"accepted":{"date-parts":[[2015,5,5]]},"published-print":{"date-parts":[[2016,8]]},"abstract":"<jats:p>We describe the case of a 23-year-old serviceman on overseas deployment who presented with a painful, swollen arm. Investigations showed an upper extremity deep vein thrombosis (UEDVT) of the right arm with an associated asymptomatic pulmonary embolism, which was treated with warfarin anticoagulation. Further investigation identified positional obstruction at the thoracic outlet, and the patient was diagnosed with Paget\u2013Schroetter syndrome. He underwent elective resection of the first rib, and has now returned to normal duties. After review of the literature on UEDVT, it is suggested that in this military patient, the occurrence of an anatomical variant put him at risk of upper limb venous thrombosis, which was probably potentiated by the occupational factor of carrying a rifle. The external compression of the subclavian vein from the rifle butt and hypertrophied muscles, in addition to the anatomical variation, caused repetitive microtrauma of the vessel intima, which precipitated venous thrombosis.<\/jats:p>","DOI":"10.1136\/jramc-2015-000418","type":"journal-article","created":{"date-parts":[[2015,6,4]],"date-time":"2015-06-04T22:55:42Z","timestamp":1433458542000},"page":"299-301","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Upper extremity deep vein thrombosis in a military patient"],"prefix":"10.1136","volume":"162","author":[{"given":"Charlotte","family":"Bullock","sequence":"first","affiliation":[{"name":"Department of Anaesthetics, Russells Hall Hospital, Dudley, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A McD","family":"Johnston","sequence":"additional","affiliation":[{"name":"Departments of Intensive Care and Respiratory Medicine, Queen Elizabeth Hospital Birmingham, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2015,6,4]]},"reference":[{"key":"2025081309214773000_162.4.299.1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.111.051276"},{"key":"2025081309214773000_162.4.299.2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcp1008740"},{"key":"2025081309214773000_162.4.299.3","doi-asserted-by":"publisher","DOI":"10.1007\/s00270-011-0148-4"},{"key":"2025081309214773000_162.4.299.4","doi-asserted-by":"publisher","DOI":"10.1016\/S0950-821X(88)80069-0"},{"key":"2025081309214773000_162.4.299.5","doi-asserted-by":"publisher","DOI":"10.1136\/emermed-2012-201374.1"},{"key":"2025081309214773000_162.4.299.6","doi-asserted-by":"publisher","DOI":"10.1111\/j.1538-7836.2008.03061.x"},{"key":"2025081309214773000_162.4.299.7","doi-asserted-by":"publisher","DOI":"10.1136\/emermed-2011-200648"},{"key":"2025081309214773000_162.4.299.8","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehn310"},{"key":"2025081309214773000_162.4.299.9","doi-asserted-by":"publisher","DOI":"10.1111\/j.1538-7836.2012.04662.x"},{"key":"2025081309214773000_162.4.299.10","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1997.00440220061008"},{"key":"2025081309214773000_162.4.299.11","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1160\/TH04-10-0640","article-title":"Post-thrombotic syndrome, functional disability and quality of life after upper extremity deep venous thrombosis in adults","volume":"93","author":"Kahn","year":"2005","journal-title":"Thromb Haemost"},{"key":"2025081309214773000_162.4.299.12","first-page":"13","article-title":"Management of subclavian-axillary vein thrombosis: a review","volume":"41","author":"Hicken","year":"1998","journal-title":"Can J Surg"},{"key":"2025081309214773000_162.4.299.13","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1002\/ajim.20888","article-title":"Work-related effort thrombosis in a millwright: a case report","volume":"54","author":"Pysklywec","year":"2011","journal-title":"Am J Ind Med"}],"container-title":["Journal of the Royal Army Medical Corps"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/jramc-2015-000418","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,13]],"date-time":"2025-08-13T16:21:55Z","timestamp":1755102115000},"score":1,"resource":{"primary":{"URL":"https:\/\/militaryhealth.bmj.com\/lookup\/doi\/10.1136\/jramc-2015-000418"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,6,4]]},"references-count":13,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2016,7,29]]},"published-print":{"date-parts":[[2016,8]]}},"alternative-id":["10.1136\/jramc-2015-000418"],"URL":"https:\/\/doi.org\/10.1136\/jramc-2015-000418","relation":{},"ISSN":["0035-8665","2052-0468"],"issn-type":[{"value":"0035-8665","type":"print"},{"value":"2052-0468","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,6,4]]}}}