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Cannot walk without pain in the legs, but can run perfectly well | ||
Differential Diagnosis | [Top] [Nav] | |
popliteal artery entrapment | ||
Discussion -- not available online | [Top] [Nav] | |
Notes | [Top] [Nav] |
* | A re-review of the literature was performed January 1996. The points below were not mentioned on the Zebra Card. | |
* | The symptoms are highly dependent on the stage of the disease. The run-good/walk-bad symptom occurs early, before repeated microtrauma to the vessel produces localized atherosclerosis. Once fixed atherosclerosis forms, the symptoms are more like run-of-the-mill claudication. An acute presentation is also possible if the artery thromboses (e.g. Husni). Some reviews did not even mention the run-good/walk-bad symptom. | |
* | It is no coincidence that athletes and military people get this. The Murray paper states that "a high degree of muscle development... unmasks occult pathology." Thus, "calf cramping after exercise in vigorous young athletes, even in the presence of good pedal pulses, should not be arbitrarily dismissed" (Darling). The Japanese may be predisposed to the condition as well, due to the way they sit (Murray). | |
* | The case reports reveal only a few instances of the run-good/walk-bad symptom (Darling). None mention a preserved ability to climb, despite one review article (Persky) mentioning this. | |
* | Another factor contributing to the variability of symptoms is the multiple anatomic variants capable of producing the syndrome. One would not be surprised if the natural history of each anatomic variant differs somewhat from the others. | |
* | The Chernoff and Erdoes papers discuss a syndrome of "functional popliteal artery entrapment," wherein no anatomic abnormality such as the other papers discuss, but occluded flow through the artery is still possible during calf muscle contraction. About 50% of all normal people have this physiology when studied, but, of course, very few have symptoms. All this article really does is: (1) complicate the diagnosis of popliteal artery entrapment, (2) make us marvel at Nature's engineering challenges. |
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Footnotes in Print Edition | [Top] [Nav] |
(1) | Another young athlete with intermittent claudication. A case report. Casscells SW, Fellows B, et al. Am J Sports Med 1983 May-Jun;11(3):180-2. Pubmed Similars | |
(2) | Intermittent claudication in young athletes: popliteal artery entrapment syndrome. Lysens RJ, Renson LM, et al. Am J Sports Med 1983 May-Jun;11(3):177-9. Pubmed Similars | |
(-) | Setting a trapped artery free. Anonymous. Emergency Medicine. 1984;16(2):65,68. Ignore this no-longer useful article. |
New References | [Top] [Nav] |
Review Articles | ||
101. | Chronic leg pain in the athlete. Clanton TO, Solcher BW. Clin Sports Med 1994 Oct;13(4):743-59. Pubmed+Abstract Similars | |
102. | Natural history of entrapment of the popliteal artery. di Marzo L, Cavallaro A, et al. J Am Coll Surg 1994 Jun;178(6):553-6. Pubmed+Abstract Similars | |
103. | Popliteal artery entrapment syndrome. Murray A, Halliday M, et al. Br J Surg 1991 Dec;78(12):1414-9. Pubmed+Abstract Similars | |
104. | Entrapment of the popliteal artery. Persky JM, Kempczinski RF, et al. Surg Gynecol Obstet 1991 Jul;173(1):84-90. Pubmed+Abstract Similars | |
Physiological investigations | ||
105. | Popliteal vascular compression in a normal population. Erdoes LS, Devine JJ, et al. J Vasc Surg 1994 Dec;20(6):978-86. Pubmed+Abstract Similars | |
106. | Asymptomatic functional popliteal artery entrapment: demonstration at MR imaging. Chernoff DM, Walker AT, et al. Radiology 1995 Apr;195(1):176-80. Pubmed+Abstract Similars | |
Case reports | ||
107. | An exceptional case of popliteal entrapment syndrome. Cairols MA, Blanes I, et al. Eur J Vasc Surg 1994 Nov;8(6):754-6. Pubmed Similars | |
108. | Surgical treatment of popliteal artery entrapment syndrome: a ten-year experience. di Marzo L, Cavallaro A, et al. Eur J Vasc Surg 1991 Feb;5(1):59-64. Pubmed+Abstract Similars | |
109. | Entrapment syndrome of the popliteal artery. Gost AL, Mestre M, et al. J Cardiovasc Surg (Torino) 1981 Jul-Aug;22(4):353-9. Pubmed Similars | |
110. | Popliteal vascular entrapment. Its increasing interest. Rich NM, Collins GJ Jr, et al. Arch Surg 1979 Dec;114(12):1377-84. Pubmed+Abstract Similars | |
111. | Intermittent claudication in young athletes: Popliteal artery entrapment syndrome. Darling RC, Buckley CJ, et al. J Trauma 1974 Jul;14(7):543-52. Pubmed Similars | |
112. | Popliteal artery entrapment by fibrous band. Haimovici H, Sprayregen S, et al. Surgery 1972 Nov;72(5):789-92. Pubmed Similars | |
113. | Popliteal artery entrapment syndrome. Gaylis H. S Afr Med J 1972 Aug 5;46(3):1071-5. Pubmed Similars | |
114. | Entrapment of the popliteal artery and its management. Husni EA, Ryu CK. Angiology 1971 Jul;22(7):380-6. Pubmed Similars | |
115. | Popliteal artery entrapment syndrome. Insua JA, Young JR, et al. Arch Surg 1970 Dec;101(6):771-5. Pubmed Similars | |
116. | Popliteal artery entrapment syndrome. Turner GR, Gosney WG, et al. JAMA 1969 Apr 28;208(4):692-3. Pubmed Similars | |
117. | Clinical syndrome of anomalous position of the popliteal artery. Servello M. Circulation. 1962;26:885-890. | |
Other | ||
118. | Handbook of Clinical Neurology. Vinken PJ, Bruyn GW. Amsterdam: North Holland: 1985;47:57. | |
119. | The illusion of certainty [see comments]. Wolinsky AP. N Engl J Med 1996 Jul 4;335(1):46-8. Pubmed Similars |
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©1986-2000 John Sotos, MD. All rights reserved. Last updated 16:35 PDT on July 4, 2000. | [Top] |