of the anatomical neck of the right humerus who had been treated with local massage. On the fourth day following injury the patient died unexpectedly and autopsy revealed an embolus in the right branch of the pulmonary artery secondary to thrombosis of the axillary and subclavian veins. Matas does not feel that this is a case of true "effort" thrombosis because the thrombus was secondary to an underlying fracture. It also seems likely that the massage was contributory to the fatal embolization.
Pathologically, there is definite evidence of inflammation of the vein and perivenous tissues. The primary injury to the endothelium of the vein is such that the thrombus is firmly adherent from its inception.9 The condition is one of true thrombophlebitis, rather than bland venous thrombosis, with firm fixation of the thrombus by the inflammatory reaction.10 This accounts for the rarity of embolization.
REPORT OF A CASE
Barnett T, Levitt LM. "EFFORT" THROMBOSIS OF THE AXILLARY VEIN WITH PULMONARY EMBOLISM. JAMA. 1951;146(15):1412–1413. doi:10.1001/jama.1951.63670150007012c