case_images: PMC6159168_01
case_images: Transverse and longitudinal images of the common femoral vein demonstrating echogenic thrombus (white asterisks).
case_images: bjrcr.20170011.g001.jpg
case_images: PMC6159168_01_bjrcr.20170011.g001.jpg
case_images: f1
case_images: Bilateral lower limb venous Doppler ultrasonography (US) revealed extensive thrombus within the left popliteal vein, superficial femoral vein with antegrade extension into the left common femoral vein (Figure 1).
case_images: Midline sagittal reconstruction CT demonstrating Grade III degenerative spondylolisthesis of the L5 vertebral body on the S1 vertebral body with evidence of spontaneous arthrodesis.
case_images: bjrcr.20170011.g002.jpg
case_images: PMC6159168_01_bjrcr.20170011.g002.jpg
case_images: f2
case_images: CT demonstrated Grade III degenerative spondylolisthesis of L5 on S1 and spontaneous spinal arthrodesis at this level (Figure 2).
case_images: Midline sagittal oblique reconstruction demonstrating variant May-Thurner syndrome secondary to lumbar degenerative spondylolisthesis. There is extensive thrombus within the expanded left external iliac vein (white circles). There is variant May-Thurner Syndrome with compression of the left common iliac vein secondary to anterior translation of the lumbar spine (white arrow heads). The course of the inferior vena cava is indicated by the white asterisks.
case_images: bjrcr.20170011.g003.jpg
case_images: PMC6159168_01_bjrcr.20170011.g003.jpg
case_images: f3
case_images: In contrast to classical May-Thurner syndrome (MTS), where a venous spur occurs at the level of compression by the right common iliac artery, in this case the length of venous compression is more extensive extending caudally to the inferior limit of the spondylolisthes (Figure 3). Extensive low-attenuation thrombus was evident within the expanded left internal iliac vein with retrograde extension into the left superficial femoral and popliteal veins (Figures 3 and 4).
case_images: Coronal reconstruction CT demonstrating compression of the left common iliac vein between the right common iliac artery (black arrow) and anteriorly translated lumbar spine (black asterisk). Low attenuation thrombus is seen within the expended left external iliac vein (white asterisk). Note left-sided soft tissue oedema secondary to deep venous thrombosis.
case_images: bjrcr.20170011.g004.jpg
case_images: PMC6159168_01_bjrcr.20170011.g004.jpg
case_images: f4
case_images: Extensive low-attenuation thrombus was evident within the expanded left internal iliac vein with retrograde extension into the left superficial femoral and popliteal veins (Figures 3 and 4).