Intermittent calf claudication without atherosclerosis, suspected cystic adventitial disease
Recommended: MRI Popliteal Region (cyst in adventitia) is the preferred imaging study for intermittent calf claudication without atherosclerosis, suspected cystic adventitial disease. Mucinous cyst in adventitia compresses popliteal artery.
Recommended study
MRI Popliteal Region (cyst in adventitia)
Mucinous cyst in adventitia compresses popliteal artery. Young / middle-aged men.
If the default doesn't apply
Catheter angiography for ambiguous case
DSA showing scimitar / hourglass sign
IV contrast
Watch-outs
Recurrence after cyst aspiration alone
Definitive treatment requires cyst excision; aspiration alone has high recurrence.
Pearls
- Scimitar sign on angiography: smooth curvilinear compression.
- MRI shows cyst in arterial wall (T2 hyperintense).
- Treatment: surgical resection of cyst + bypass if needed.