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避免误诊陷阱:从一例长期腘动脉压迫综合征病例中获得的宝贵教学要点

Avoiding the Trap of Misdiagnosis: Valuable Teaching Points Derived from a Case of Longstanding Popliteal Artery Entrapment Syndrome.

作者信息

Wady Heitham, Badar Zain, Farooq Zerwa, Shaw Palma, Kobayashi Katsuhiro

机构信息

SUNY Upstate Medical Center, Syracuse, NY, USA.

出版信息

Case Rep Med. 2018 Feb 14;2018:3214561. doi: 10.1155/2018/3214561. eCollection 2018.

Abstract

Popliteal artery entrapment syndrome (PAES), a condition predominantly affecting young individuals, is a rare clinical entity that can result in significant morbidity. The presence of lower limb pain and claudication in young, physically active individuals should prompt consideration for PAES. Early diagnosis and management is crucial to prevent long-term complications; however, diagnosis is fraught with challenges due to the rarity of the disease and its similar clinical presentation with more common conditions. We present a case of a young female with PAES who was misdiagnosed and underwent a tarsal tunnel release for suspected tarsal tunnel syndrome and subsequent fasciotomies for presumed chronic exertional compartment syndrome (CECS) without any relief. We outline the insidious undiagnosed course of her condition over a period of 12 years, discuss teaching points of how to recognize key differences of PAES and associated conditions, and provide recommendations for how to make the right diagnosis.

摘要

腘动脉压迫综合征(PAES)主要影响年轻人,是一种罕见的临床病症,可导致严重的发病情况。在年轻、身体活跃的个体中出现下肢疼痛和间歇性跛行应促使考虑PAES。早期诊断和治疗对于预防长期并发症至关重要;然而,由于该疾病罕见且其临床表现与更常见病症相似,诊断充满挑战。我们报告一例患有PAES的年轻女性病例,她被误诊,因疑似跗管综合征接受了跗管松解术,随后又因推测的慢性运动性骨筋膜室综合征(CECS)进行了筋膜切开术,但均无缓解。我们概述了她在12年期间病情未被诊断的隐匿过程,讨论了如何识别PAES及相关病症关键差异的教学要点,并提供了如何做出正确诊断的建议。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/702b/5832165/b6758067c412/CRIM2018-3214561.001.jpg

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