Background and Aims Osteoarthritis of the knee is a degenerative joint disease with progressive degradation of articular cartilage and subchondral bone due to continuous wear, additional stress and overload. Symptoms depending on the stage of the desease may include joint pain, tenderness, stiffness, locking, and sometimes an effusion. Pain can be managed with minimal invasive treatments, such as genicular nerve block and cryoablation therapy.

Methods 82-year-old patient with a history of arterial hypertension, idiopathic bilateral pulmonary thromboembolism, osteoarticular disease and patella fracture, medicated with apixaban 5 mg 12/12h. Patient with previous positive diagnostic block of the right geniculate nerves and total pain relief, is admitted for cryoablation, after telephone information of recurrence of symptoms. Anticoagulant suspension was indicated 72 hours before the procedure.

Results The objective examination revealed controlled gonalgia, but pain on palpation of the posterior region of the homolateral leg, slight edema and skin color change. An ultrasound scan was performed, identifying significant partial occlusion of the popliteal vein, for this reason the patient was sent to the emergency department.

Conclusions Patients with chronic pain tend to have their pain undervalued by family members and some health professionals, and acute events may be overlooked. The careful assessment of the patient and the appreciation of new painful events guarantees a careful and safe follow-up, as well as possible life-threatening diagnoses.