Abstract
Vascular causes of exertional lower extremity pain are relatively rare, but may be the answer in athletes refractory to treatment for the more common overuse syndromes of the lower extremities. Important vascular etiologies to be considered are popliteal artery entrapment syndrome (PAES), iliac artery endofibrosis (IAE), popliteal artery aneurysm (PAA), cystic adventitial disease.
It is important to differentiate these vascular causes from chronic musculoskeletal syndromes. Because all of these conditions may present with pain or intermittent claudication, imaging is crucial for differentiating them and directing management.
The diagnostic workup involves digital subtraction angiography (DSA) or noninvasive vascular studies such as Doppler ultrasound or computed tomography angiography (CTA) or magnetic resonance angiography (MRA) in the provocative positions. Delayed diagnosis can lead to major complications, including acute limb ischemia.
Treatment of these vascular abnormalities typically involves surgical correction. Our aim is to provide an overview of these conditions in order to make physicians aware of them and avoid misdiagnosis for timely appropriate management.