CTICasesThrombophlebitis in a Lupus Patient
Imaging findings
Chest radiograph shows a peripherally inserted central catheter (PICC) taking a highly tortuous, circuitous, 'corkscrew' path within the left subclavian and brachiocephalic veins, rather than a straight course.
Key takeaways
A central venous catheter or PICC line that takes a tortuous or corkscrew course on radiographs indicates that it is not floating freely within a patent lumen, which is a strong indirect sign of surrounding venous thrombosis or stricture, especially in hypercoagulable patients such as those with systemic lupus erythematosus (SLE).
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