Exercise-induced popliteal artery compression due to a popliteal fossa cyst.

Nonatherosclerotic extrinsic compression from para-articular cysts is a rare but clinically important cause of claudication. We report the case of a 50-year-old man who presented with left calf claudication and absence of distal left dorsalis pedis artery pulse after exertion. A duplex ultrasound study revealed a popliteal fossa cyst that doubled in size under exertion (from 3.2 to 7.2 mm), leading to an extrinsic compression of the popliteal artery. Magnetic resonance imaging scans confirmed a possible articular origin of the cyst. Dense adhesions surrounding the lesion led to the reconstruction of both the left popliteal artery and left popliteal vein. This case highlights the importance of implementing exercise during duplex ultrasound study of lower limbs to identify rare exercise-induced enlargement of popliteal cysts causing popliteal artery stenosis, which may subsequently require complex multivessel surgical management.