When rare conditions collide: plantar vein thrombosis in hereditary spherocytosis

Abstract

Plantar heel pain is a common orthopedic complaint, but less frequent etiologies like plantar vein thrombosis (PVT) are often overlooked. We present the case of a 27-year-old female with a history of hereditary spherocytosis who developed left plantar foot pain shortly after starting combined oral contraceptives. Initially suspected to be plantar fasciitis, conservative treatment provided no relief. Imaging studies, including Doppler ultrasonography and MRI, revealed a thrombus in the medial plantar vein. The patient was successfully treated with a 30-day course of anticoagulation therapy using enoxaparin, followed by acetylsalicylic acid. Her symptoms resolved completely, and she remained asymptomatic at a one-year follow-up. This unique case highlights the importance of considering PVT in the differential diagnosis of atypical foot pain, particularly in patients with a history of thrombotic risk factors, to ensure early and effective treatment. Level evidence IV.