Intramuscular Haematoma in the Upper Arm

Clinical History

A 42-year old lady with a recent history of a peripherally inserted central catheter (PICC line) insertion in her left upper arm developed an acute onset of pain and swelling around the PICC line insertion.

Ultrasound of the arm was requested to rule out venous thrombosis or soft tissue haematoma or collection.

Case Description

Ultrasound revealed a 7 cm hypoechoic, heterogeneous, and non-vascular structure within the intramuscular layer of the brachium deep to the site of the line insertion. Appearances were suggestive of an intramuscular haematoma. 

In addition to the recent PICC line insertion, the patient had other preexisting conditions that supports the ultrasound findings

Diagnosis/ Discussion/ Treatment/ Follow up

The patient was continually managed for her comorbidities while the arm haematoma was managed conservatively. However, prior anticoagulation therapy (for other comorbidities) was discontinued.

Sonograms