How to assess for popliteal entrapment syndrome?
Popliteal entrapment syndrome is an uncommon condition that typically affects young athletic men who present with calf claudication.
On imaging, popliteal artery patency is assessed in both stress and rest positions, where stress is achieved by dorsiflexion or plantar flexion. Entrapment of the popliteal artery is usually, but not always, a result of an abnormal anatomic relationship with the medial head of the gastrocnemius muscle, in which the popliteal artery is more medially located than it should be. In some cases, the popliteal artery is normally positioned but is entrapped by a hypertrophied gastrocnemius muscle.
In patients with suspected popliteal entrapment syndrome, MRA is preferred to CTA. Both lower extremities are imaged because the condition is bilateral in ≈25% of cases.