Popliteal entrapment as a result of neurovascular compression by the soleus and plantaris muscles

Turnipseed, William D.; Pozniak, Myron A.

doi:10.1016/0741-5214(92)90250-c

Cited by 96 publications

(84 citation statements)

References 12 publications

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“…The diagnostic algorithm is easy to follow by any (musculoskeletal) radiologist with experience in HRUS and similar to the plethysmographic algorithm presented by Turnipseed et al for patients with atypical lower leg claudication [12]: first, the entry of the TN under the SA is located by following the TN distally. The SA is usually found around 9 cm distally to the medial tibia plateau [13], where cross-section areas and regional blurring/loss of fascicular texture of the TN can be evaluated.…”

Section: Discussionmentioning

confidence: 99%

A rare case of an acute soleus arcade syndrome complicated by a ganglion cyst: diagnosis by dynamic ultrasound

et al. 2017

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The soleus arcade syndrome is a rare compression neuropathy of the tibial nerve that often remains undiagnosed due to low clinical awareness and difficult diagnosis. We present the case of a female patient admitted with acute worsening of a pre-existing sensory tibial neuropathy and acute tibial nerve palsy after knee joint injection. After a knee magnetic resonance imaging remained non-diagnostic, dynamic ultrasonography was performed. Constriction by the soleus arcade and proximal swelling of the tibial nerve could be demonstrated during plantarflexion of the ankle by means of a dynamic examination in the standing patient. The patient underwent surgery and recovered fully. This proposed diagnostic approach can be used to identify soleus arcade syndrome by ultrasound.

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Section: Discussionmentioning

confidence: 99%

A rare case of an acute soleus arcade syndrome complicated by a ganglion cyst: diagnosis by dynamic ultrasound

et al. 2017

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“…It has been proposed that this represents lateral displacement of the entire neurovascular bundle against the lateral angle of the soleal sling and the lateral condyle of the tibia, and that functional entrapment lies at the opposite end of the spectrum from normal physiology [14][15][16][17].…”

Section: Opinion Statementmentioning

confidence: 99%

Popliteal artery entrapment syndrome

Henry

Wilkins

Lambert

2004

Curr Treat Options Cardio Med

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Popliteal artery entrapment syndrome is a condition caused by direct compression of the popliteal artery as it passes within or exits the popliteal fossa. It is surprisingly uncommon and usually affects young patients, typically men, and often presenting with symptoms of claudication, or more rarely acute limb ischemia, calf cramps, or a picture of compartment syndrome. The diagnosis should be considered early within the differential diagnosis of all patients presenting with these problems in this age group. The key to management of this condition lies in a high index of suspicion. The treatment of popliteal artery entrapment syndrome is surgical. When the condition is detected at an early stage surgery may be limited to release of the artery alone. However, if the artery has been compressed for some time the resulting intimal damage necessitates bypass of the affected segment. There are numerous reports of thrombectomy with simple vein patching, but the results are inferior to interpositional vein grafting. Reports have also been published of attempts made at endovascular treatment. At present, this mode of management adds little to the definitive treatment of affected limbs and appears limited to use as a bridging procedure in cases presenting with limb ischemia. Unfortunately, an effective clinical screening test does not exist and imaging remains the mainstay in the diagnosis of symptomatic limbs and the screening of asymptomatic limbs. The exact modality of imaging remains unclear, but for the moment duplex scanning, angiography, computed tomography, and magnetic resonance imaging all appear to have their place.

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“…However, the patient's symptoms must always be considered, because popliteal occlusion at stress maneuver can be found in more than 50% of healthy people. 4,[8][9][10] Computed tomography scan shows artery occlusion, but it is not always able to delineate anomalous insertion of muscle. Magnetic resonance angiography provides detailed information regarding the relationship between vascular and musculotendinous structures within and around the popliteal fossa.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3]6 Different diagnoses include arteritis, neurogenic claudication, muscular disease, tumors in popliteal adventitial cavity, cystic disease of the popliteal artery and injuries to the popliteal artery affected by traumatic causes. 4,[7][8][9] The syndrome can be divided into two categories: anatomic and functional entrapment. 8 In spite of that, the most acceptable is Rich's classification into five types, based on the embryologic aspect.…”

Section: Discussionmentioning

confidence: 99%

Bilateral popliteal artery entrapment syndrome: case report

et al. 2008

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Popliteal artery entrapment syndrome occurs due to an extrinsic compression of the popliteal vessels that results in vascular damage. It is one of the most frequent causes of intermittent claudication in young patients. The authors describe a case of bilateral syndrome by anomalous position of the gastrocnemius muscle, with abnormal slip of its medial head (Rich's type III). During the operation the occluded right side was reconstructed by autologous saphenous vein bypass from femoral superficial to peroneal artery and on the left side the slip muscle was transected by posterior approach. Popliteal artery entrapment syndrome should be treated by surgery despite the degree of symptoms. Surgical treatment technique has released the vessel by extracting the muscle that caused entrapment, and reconstructing the narrow lumen bypass grafting.Keywords: Popliteal artery, surgery, popliteal artery entrapment syndrome. ResumoA síndrome do aprisionamento da artéria poplítea ocorre em função de compressão extrínseca dos vasos poplíteos, que resulta em lesão vascular. Trata-se de uma das causas mais freqüentes de claudicação intermitente em pacientes jovens. Os autores descrevem um caso de síndrome bilateral devida à posição anômala do músculo gastrocnêmio, com deslizamento de sua cabeça média (tipo III da classificação de Rich). Durante a cirurgia, o lado direito ocluído foi reconstruído por derivação da veia safena autóloga da artéria superficial femoral para a artéria peroneal e, do lado esquerdo, o músculo que sofreu o deslizamento foi secionado através de via posterior. A síndrome do aprisionamento da artéria poplítea deve ser tratada por cirurgia, independente do grau dos sintomas. A técnica de tratamento cirúrgico liberou o vaso, extraindo o músculo que causava o aprisionamento e reconstruindo o lúmen estreito por derivação. Palavras-chave:Artéria poplítea, cirurgia, síndrome do aprisionamento da artéria poplítea.

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Popliteal entrapment as a result of neurovascular compression by the soleus and plantaris muscles

Cited by 96 publications

References 12 publications

A rare case of an acute soleus arcade syndrome complicated by a ganglion cyst: diagnosis by dynamic ultrasound

A rare case of an acute soleus arcade syndrome complicated by a ganglion cyst: diagnosis by dynamic ultrasound

Popliteal artery entrapment syndrome

Bilateral popliteal artery entrapment syndrome: case report

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