Left foot & ankle Xray (standing, 3 views): No acute fracture, misalignment, or other abnormalities.
Lower extremity Doppler: Moderate left infrapopliteal level occlusive arterial disease with diminished ABI in left lower extremity pre- and post-exercise.
CTA (Abdomen, pelvis, lower extremity): Left popliteal artery entrapment by the thin portion of the medial head of the gastrocnemius muscle without evidence of arteritis. Otherwise, normal.
Bilateral MRI/MRA lower extremity: The left gastrocnemius muscle medial head inserts more laterally than normal. The tendon travels between the popliteal artery and vein causing occlusion at the knee joint level. The right popliteal artery shows significant narrowing with plantar flexion, minimal narrowing with dorsiflexion, and is widely patent in neutral without definite evidence of anatomical compression.
Case poster Case Photo #1
Pediatric Cardiology, Pediatric Sports medicine, Vascular surgery
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