Repetitive Calf-Raise Pulse Provocative Test for Popliteal Artery Entrapment Syndrome

Popliteal artery entrapment syndrome (PAES) is a rare cause of exertional leg pain in young adults, which is caused by compression of the popliteal artery by the surrounding muscular structure. Due to significant overlap in symptoms with other conditions, limitations of diagnostic imaging, and lack of awareness, PAES is frequently misdiagnosed, resulting in late complications and poor prognosis. Clinical assessment is crucial in making the initial diagnosis and referring for relevant investigations for PAES. In this case report, we have discussed the utility of the repetitive calf-raise pulse (RCRP) test as an easy, accessible bedside provocative test that can be used to diagnose PAES during the initial assessment. The RCRP test, which involves repetitive raises followed by an examination of distal pulses, has not been studied properly, and there is very scant literature regarding this. However, it follows the same underlying principles as Doppler with provocative manoeuvres. We have described a new and novel test for screening PAES, and the adoption of this test for people presenting with exertional leg pain can minimise the likelihood of misdiagnosis by referring selected patients to the appropriate diagnostic pathway.