[Popliteal aneurysms: clinical aspects and diagnosis]

To identify clinical and radiological features allowing an early diagnosis of popliteal aneurysms.

History, clinical features and radiological findings of 23 patients with 37 aneurysms were reviewed.

14 patients presented with a history of a sudden onset of rest pain localised in the calf or foot. Arteriography found popliteal artery occlusion in 12 of them. Amputation was necessary in one patient in spite of immediate diagnosis and therapy. In two cases embolisation of the tibial vessels caused intermittent claudication. In at least 7 patients the underlying disease was not suspected until arteriography was performed. In 16/23 patients the presence of thrombus prevented direct visualisation of the aneurysm and there were only secondary angiographic signs of the underlying condition. Thus, arteriography may fail to diagnose popliteal aneurysms. In 21/22 cases colour Doppler sonography was quick and accurate in the assessment of patent and thrombosed aneurysms.

In any patient with ischaemic symptoms of the lower extremity a thorough palpation of the popliteal fossa should be performed. In patients with a prominent popliteal pulse, in pulseless popliteal tumours and in patients arteriographically shown to have popliteal artery occlusion, a sonographic study of both popliteal fossae should be performed.