DOI:10.2214/AJR.06.1337
AJR 2007; 188:W491
© American Roentgen Ray Society
"eThrombosis": Are Radiologists at Risk?
Perry S. Gerard1,
Paul Gerczuk1 and
Matthew Mattern2
1 Maimonides Medical Center, Brooklyn, NY 11219
2 Wake Forest University, Baptist Medical Center, Winston-Salem, NC
27157
WEB—This is a Web exclusive article.
Few would argue that the job of the radiologist is not a sedentary one,
often requiring sitting at a computer for hours at a time. With more and more
radiologic studies being ordered, it is easy to find oneself glued to the seat
for most of the day. However, in light of recent reports of venous thrombosis
after prolonged computer use, one should think twice about reviewing that next
film without a break.
"eThrombosis," a term for venous thrombosis occurring from
prolonged computer use, was first reported by Beasley et al.
[1] in 2003. The authors
described a 32-year-old man who suffered a life-threatening pulmonary
thromboembolism whose only known risk factor was regularly working 12-hour
days at a computer. Another report described a healthy 12-year-old boy who
developed a deep vein thrombosis while playing a computer game for 4
consecutive hours with his legs flexed
[2]. More recently, a
24-year-old Korean man died from a pulmonary thromboembolism after playing a
computer game continuously for nearly 4 days with little sleep
[3].
The prothrombotic effects of extended air and automobile travel,
"traveler's thrombosis," have been known for some time. There have
also been reports of venous thrombosis in those who sit in theaters for
extended periods of time [3,
4]. The term "seated
immobility thromboembolism (SIT) syndrome" has been introduced to
encompass all conditions in which a state of prolonged sitting is found to be
the major risk factor in patients presenting with venous thromboembolism (VTE)
[5].
In light of these reports, it is reasonable to predict that radiologists
are at a higher risk for VTE than the general population. The average
radiologist is not only spending most of the day on the computer but is also
working for dangerously long periods of time without taking a break. Merely 2
hours of sitting has been shown to increase blood viscosity and the tendency
for thrombosis in the lower extremities
[4].
There are certain measures that anyone who works at a computer can do to
avoid VTE. For example, don't dictate for hours on end without standing up.
Reach for a cup of water instead of a cup of coffee to keep the body well
hydrated. When seated, keep your legs uncrossed and knees bent because this
will prevent venous stasis. Periodically flexing the thigh muscles, pumping
the calves, and moving the feet will increase circulation and venous return
from the legs, decreasing the likelihood of deep vein thrombosis
formation.
References
- Beasley R, Raymond N, Hill S, Nowitz M, Hughes R. eThrombosis: the
21st century variant of venous thromboembolism associated with immobility.
Eur Respir J 2003;21
: 374-376[Abstract/Free Full Text]
- Ng SM, Khurana RM, Yeang HW, Hughes UM, Manning DJ. Is prolonged
use of computer games a risk factor for deep venous thrombosis in children?
Clin Med 2003; 3:593
-594[Medline]
- Lee H. A new case of fatal pulmonary thromboembolism associated
with prolonged sitting at computer in Korea. Yonsei Med
J 2004; 45:349
-351[Medline]
- Homans J. Thrombosis of the deep leg veins due to prolonged
sitting. N Engl J Med 1954;250
: 148-149[Medline]
- Beasley R, Heuser P, Masoi M. One name to rule them all, one name
to find them: Lord of the Rings and "seated immobility thromboembolism
(SIT) syndrome." N Z Med J 2003;166
: U498
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