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Journal of Sports Medicine
Volume 2014, Article ID 105953, 8 pages
http://dx.doi.org/10.1155/2014/105953
Review Article

Functional Popliteal Artery Entrapment Syndrome: Poorly Understood and Frequently Missed? A Review of Clinical Features, Appropriate Investigations, and Treatment Options

1Brisbane Sports and Exercise Medicine Specialists Clinic, 87 Riding Road, Brisbane, QLD 4171, Australia
2Queensland X-Ray, Greenslopes Private Hospital, Brisbane, QLD 4120, Australia

Received 15 June 2014; Revised 12 August 2014; Accepted 18 August 2014; Published 7 September 2014

Academic Editor: Adrian W. Midgley

Copyright © 2014 Matthew Hislop et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Functional popliteal artery entrapment syndrome (PAES) is an important and possibly underrecognized cause of exertional leg pain (ELP). As it is poorly understood, it is at risk of misdiagnosis and mismanagement. The features indicative of PAES are outlined, as it can share features with other causes of ELP. Investigating functional PAES is also fraught with potential problems and if it is performed incorrectly, it can result in false negative and false positive findings. A review of the current vascular investigations is provided, highlighting some of the limitations standard tests have in determining functional PAES. Once a clinical suspicion for PAES is satisfied, it is necessary to further distinguish the subcategories of anatomical and functional entrapment and the group of asymptomatic occluders. When definitive entrapment is confirmed, it is important to identify the level of entrapment so that precise intervention can be performed. Treatment strategies for functional PAES are discussed, including the possibility of a new, less invasive intervention of guided Botulinum toxin injection at the level of entrapment as an alternative to vascular surgery.