What’s the Diagnosis – Case 107
1
What’s the Diagnosis – Case 107
2
What’s the Diagnosis – Case 107
3
What’s the Diagnosis – Case 107
4
What’s the Diagnosis – Case 107
5
What’s the Diagnosis – Case 107
6
What’s the Diagnosis – Case 107
7
What’s the Diagnosis – Case 107
8
What’s the Diagnosis – Case 107
9
What’s the Diagnosis – Case 107
10
Findings On both the neutral and plantar flexion angiogram images there is eccentric compression about the popliteal artery. This does not change between the two images. On the routine MR images there are cysts surrounding the popliteal artery causing compression of the popliteal artery. No abnormality of the gastrocnemius is present.
What’s the Diagnosis – Case 107
11
What’s the Diagnosis – Case 107
12
What’s the Diagnosis – Case 107
13
What’s the Diagnosis – Case 107
14
What’s the Diagnosis – Case 107
15
What’s the Diagnosis – Case 107
16
What’s the Diagnosis – Case 107
17
What’s the Diagnosis – Case 107
18
What’s the Diagnosis – Case 107
19
What’s the Diagnosis – Case 107
20
Diagnosis: Cystic Adventitial Disease of the Popliteal Artery A rare entity and infrequently encountered in musculoskeletal imaging. This disease is most frequently found in men 40-50 years of age that present with increasing pain with activity or intermittent claudication. The cysts yield compression of the popliteal artery in a number of patterns. This process can be treated by multiple surgical procedures typically separated at attempt to remove or evacuate the cysts or resect the vessel and performing direct anastomosis or graft interposition. Another entity that has to be distinguished is popliteal entrapment syndrome. Popliteal entrapment syndrome can have multiple causes as well but most frequently relates to an abnormal or variant course of the medial head of the gastrocnemius. With activity, this leads to increased compression of the popliteal artery. With plantar flexion and contraction of the gastrocnemius, there would be expected increased compression of the popliteal artery.
What’s the Diagnosis – Case 107
21
References Surgical Treatment of Cystic Adventitial Disease of the Popliteal Artery: Five Case Reports. Kimihiro Igari, Toshifumi Kudo, Takahiro Toyofuku, and Yoshinori Inoue. Case Reports in Vascular Medicine. Volume 2015 (2015), Article ID 984681. Case 157: Bilateral Adventitial Cystic Disease of the Popliteal Artery. RSNA Radiology. May 2010,Volume 255, Issue 2.
What’s the Diagnosis – Case 107
22