[Entrapment-syndrome of the popliteal artery: morphological and functional diagnosis using MRT inclusive provocation...

A 30-year old man with pain in the right calf was submitted. Typical cardiovascular risk factors were excluded. Contrast enhanced MR-angiography at rest showed occlusion of right popliteal artery with collateral vessels due to an abnormal origin of medial head of gastrocnemius muscle at femoral diaphysis. In contrast to a normal MR-angiography at rest the exercise test detected a lateral deviation and a severe functional stenosis of the left popliteal artery. This was caused by an abnormal medial origin of medial head of gastrocnemius muscle at the inner femoral condylus. The patient has been treated with vascular reconstruction combined with myectomy on the right side and with myectomy only on the left side. These findings showed two different types of popliteal artery entrapment syndrome in one patient. MRI is able to detect the different types especially in different stages. Irreversible damages of popliteal artery in early diagnosed stages may thereby be prevented.