A 25 year-old Middle Eastern male with a 6 year history of recurrent deep venous thrombi despite therapeutic anticoagulation presented to a vascular medicine specialist . Physical examination demonstrated painful erythematous lesions over the lateral aspect of the calf (A, Courtesy Dr. Steven Dean) and oral ulcerations. B. Subsequent contrast-enhanced magnetic resonance venogram showed occlusion of a previously placed filter in the inferior vena cava (arrowhead). Extensive venous collaterals are evident. C. Coronal plane post-contrast volumetric interpolated breathhold T1-weighted image shows signal void delineating the IVC filter (arrows).