25-year-old With Exertional Calf Pain - Page #4

Working Diagnosis:
Bilateral Popliteal Artery Entrapment Syndrome with left lower leg claudication secondary to popliteal artery occlusion.

Right and left sided popliteal artery entrapment release via transection of aberrant, medial gastrocnemius muscle and tendon, and left-sided interposition graft.

Patient's postoperative course was uncomplicated. He was discharged home ambulatory after 4 days. Arterial doppler and ankle brachial indices returned to normal postoperatively. He resumed running one month postop without difficulty or recurrence of his pain. He returned to weightlifting after two and a half month postoperatively with occasional brief pain at the surgical site but no recurrence of prior symptoms.

Editor's Comments:
This case highlights the importance of a thorough and careful vascular exam when evaluating lower extremity symptoms that may initially appear to be of musculoskeletal etiology. Oftentimes, the vascular exam reveals subtle, but highly important findings. In this case, there was subtle paleness of the skin in the left foot and a slightly diminished pulse. Once a vascular etiology was suspected, additional tests were done to uncover a rare cause of the patient's calf pain.

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