Adventitial cystic disease of the popliteal artery

Janne Elst
A 56-year-old male presents with hypoesthesia in the calf and lateral foot, corresponding to the innervation of the tibial nerve and pain in the popliteal fossa since many years. Since 2 months, the patient also suffers from claudication, causing pain in his lower extremities after a walking distance of 200 meters (stage IIa, Fontaine classification). Imaging Findings Ultrasound (Fig. 1) shows a multilocular hypoechoic structure with retro-acoustic enhancement surrounding the popliteal artery.
more » ... popliteal artery. There is absence of flow in the lesion on color Doppler examination. Subsequent CT angiography (Fig. 2) shows an occlusion of the popliteal artery. There are no significant signs of degenerative atherosclerosis. MRI (Fig. 3) confirms an extensive multilocular cystic lesion adjacent to the popliteal artery with a connecting stalk to the joint space . There is significant mass effect on the neurovascular bundle.
doi:10.1594/eurorad/case.14793 fatcat:6vlcik4yv5bipfbtxtowrklihe