Intermittent claudication in an athlete--popliteal artery entrapment: a case report

This case study reports a 26 year old female athlete who presented with a history of cramp-like right calf pain. She was limited to a walking distance of only three blocks. She had been referred to the Sports Medicine Clinic with a diagnosis of "shin splints". On examination of the pedal pulses it was found that the right posterior tibial pulse was absent. A diagnosis of popliteal artery entrapment was made which was confirmed by Doppler studies following treadmill walking and femoral arteriograms. Surgery was performed which included resection of the entrapped artery by the plantaris tendon and endarterectomy, plus patch graft angioplasty. The artery had been completely occluded. The patient resumed full activity pain free. This case report emphasizes that all leg pains in athletes are not variants of "shin splints". Popliteal artery entrapment is an uncommon condition that requires early detection. A detailed history and thorough examination of the peripheral pulses is essential to prevent long term sequelae of arterial deficiency.