Síndrome do aprisionamento poplíteo e síndrome compartimental crônica dos membros inferiores: desafios no diagnóstico e tratamento

Síndrome de aprisionamento da artéria poplítea como diagnóstico diferencial de dor no joelho: Um relato de caso

“…Popliteal artery entrapment syndrome is the leading cause of intermittent claudication in young patients without atherosclerotic disease etiologies, 2,3 and one of the differential diagnoses of lower limb pain, along with tibial stress syndrome, stress fractures, arteritis, myopathies, popliteal artery cyst, and tendinopathies. 1,4 Popliteal artery entrapment results in significant symptoms in the lower limbs, including pain, paresthesia, and physical exertion-triggered pallor. 2,4 Lamônica et al 5 demonstrated that semiological maneuvers of foot dorsiflexion or flexion caused reduced or absent posterior tibial and dorsalis pedis pulses due to compression of the popliteal artery from the contraction of the adjacent muscles, as shown in the physical examination of our patient.…”

“…There are six types of PAES, 2,5 namely: The case herein reported is classified as type III since the MRI showed an anatomical variation, that is, an accessory band at the origin of the lateral gastrocnemius, which compresses the popliteal artery against the femoral condyle during muscle contraction. 4 It is worth noting that surgery is the treatment of choice for popliteal artery extrication even in asymptomatic patients 2 because of PAES complications, including arterial thrombosis from repeated vascular damage, thromboembolism, or vascular aneurysm. 1 Furthermore, the approach to the popliteal fossa occurs through an S-shaped incision to fold the popliteal face after surgery.…”

“…1 Furthermore, the approach to the popliteal fossa occurs through an S-shaped incision to fold the popliteal face after surgery. 4 In type-III PAES, after identifying the accessory band, it is necessary to perform its resection to extricate the popliteal artery. 3 The present case report shows the significant role of surgical treatment in decompressing the popliteal artery to alleviate symptoms and prevent potential complications.…”

Síndrome do aprisionamento da artéria poplítea: relato de caso

“…Ao exame físico, pode-se identificar uma redução da amplitude dos pulsos tibial posterior e dorsal do pé durante dorsiflexão ou hiperextensão plantar. Somado a isso, exames podem ser atribuídos para identificação da compressão da artéria e estruturas envolvidas sendo estes o mapeamento dúplex (MD), a ressonância nuclear magnética (RNM) e a angiotomografia computadorizada (ATC) 6 .…”

“…Em meio aos diagnósticos diferenciais, destacam-se doenças ortopédicas como a síndrome do estresse tibial, fraturas por estresse e tendinopatias. Outra condição também presente em pacientes na mesma faixa etária é a Síndrome Compartimental Crônica (SCC), quando os pulsos são palpáveis, levando ao endurecimento muscular, fraqueza ou formigamento na face anterolateral ou posterior das pernas com irradiação para o pé e panturrilhas 6 .…”