Popliteal artery entrapment syndrome introduction Popliteal artery entrapment syndrome (PAES) is an underreported condition affecting the lower extremities in active individuals.
Popliteal artery entrapment syndrome introduction Popliteal artery entrapment syndrome (PAES) is an underreported condition affecting the lower extremities in active individuals. It was first described anatomically in 1879 by a medical student, T.P. Stuart, performing a cadaveric dissection, who noted “The popliteal artery, after passing through the opening in the adductor magnus, instead of, as it usually does, coursing downwards and outwards towards the middle of the popliteal space, so as to lie between the two heads of the gastrocnemius muscle, passes almost vertically downwards internally to the inner head of the gastrocnemius.
It reaches the bottom of the space by turning round the inner border of that head, and then passes downwards and outwards beneath it—between it and the lower end of the shaft of the femur. The reported incidence of popliteal artery entrapment syndrome ranges from 0.6% to 3.5%. However, the prevalence of asymptomatic popliteal artery occlusion is estimated to be as high as 80%.
Bilateral disease is found in up to two-thirds of cases , and 1 study suggested a 15:1 male to female ratio. Most of the current knowledge of popliteal artery entrapment syndrome is based on case studies, making the true incidence of the syndrome difficult to ascertain. Popliteal artery entrapment syndrome is characterized by two broad categories: congenital or anatomic and functional.
Anatomic variants found in popliteal artery entrapment syndrome tend to occur in older men who are greater than 40 years of age with lower functional demands, and the functional variants are due to hypertrophy of a normal medial gastrocnemius muscle and tend to present in highly conditioned women who are 20 to 29 years of age. The most widely accepted classification system, proposed by Love and Whelan in 1965 and modified by Rich and colleagues in 1979, divides PAES into six subtypes. The presenting symptoms can be variable and may change depending on the acuity, chronicity, and extent of the pathology.
There is overlap between symptoms with exertional compartment syndrome and one must be aware of both diagnoses when evaluating an individual with leg pain. Individuals may also report concomitant back pain, which can lead the provider to feel symptoms are more related to the lumbar spine. A helpful differentiating factor in the physical examination is the location of pain.
If you are experiencing symptoms that may be related to popliteal artery entrapment syndrome, it is important to see a sports medicine physician. Early evaluation and treatment typically lead to better outcomes. Do not ignore pain or symptoms that are limiting your activity.
*This article is for educational purposes only and does not substitute for professional medical advice. Always consult a qualified healthcare provider.*
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