A 19-year-old male athlete develops unilateral calf claudication that appears reproducibly after running and resolves with rest. Pulses are normal at rest but the pedal pulse disappears on forced passive dorsiflexion of the ankle. Arteriography shows medial deviation of the popliteal artery. The most likely diagnosis is:
- A Popliteal artery entrapment syndrome ✓
- B Adventitial cystic disease of the popliteal artery
- C Buerger disease
- D Persistent sciatic artery
Correct answer: A. Popliteal artery entrapment syndrome
Explanation
Popliteal artery entrapment is caused by an anomalous relationship between the popliteal artery and the medial head of gastrocnemius or other myofascial bands. It affects young athletes, produces reproducible exercise claudication, loss of pedal pulse on active plantarflexion or passive dorsiflexion, and medial deviation of the artery on angiography. Adventitial cystic disease causes focal stenosis with a scimitar sign in middle-aged men, not positional pulse loss.
Reference: Rutherford's Vascular Surgery and Endovascular Therapy, 9th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.