[True and false popliteal artery entrapment in sportsmen]

Popliteal artery entrapment and its various anatomical type I, II, III and IV has been perfectly described in previous studies. The only test that diagnoses true entrapment due to an anatomical abnormality in the course of the popliteal artery, where it is tied by an embryonic anomaly, is passive dorsiflexion of the foot on the extended leg the deviation then observed at ultrasonography and angiography and the disappearance of downstream signal at doppler examination are pathognomonic. Ultrasonography, computerized tomography (CT) and, more recently, nuclear magnetic resonance (NMR) provide detailed information on the abnormality: separation of the artery from the vein by a muscular bridge is the hallmark of true popliteal entrapment. On the other hand, there is a functional pathology due to dynamic compression of the popliteal artery by the medial gastrocnemius muscle, which raises difficult diagnostic and therapeutic problems, especially in high-level sportsmen for whom the leg muscle activity is very important. In these subjects with a developed muscular mass the medial gastrocnemius muscle crushes the popliteal artery against the femoral condyle without deviation of the artery, particularly in active dorsiflexion and activity hyperextension of the foot on the extended leg. In such case, the popliteal artery and vein remain close to each other, as demonstrated by ultrasounds, CT and NMR. True popliteal artery entrapment can be cured by surgery with subsequent resumption of sporting activities, but whether false entrapment must be operated is difficult to decide. Surgery has been performed with success in some cases of highly disabling false entrapment due to compression of the artery by the medical gastrocnemius muscle.(ABSTRACT TRUNCATED AT 250 WORDS)