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Urschel’s Sign in Paget Schroetter Syndrome

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A 32-year-old man, employed as a deckhand, was referred for right upper extremity swelling and pain of 3 months' duration. Physical examination revealed swelling of the right upper extremity and prominent superficial veins over the right upper arm and shoulder (Urschel's sign; Figure). Blood work including thrombophilia screen was unremarkable. Right upper extremity venous duplex ultrasonography and computed tomography venogram...