Actually, I am looking for suggestions for other bulletin boards that might shed light on very perplexing symptoms my daughter’s friend has. Following strenuous exercise she has severe syptoms of calf claudication. She has been to about 10 specialists, half of them from Johns Hopkins with thoughts ranging from compartment syndrome to spinal stenosis to vascular congenital anomaly to popliteal impingement syndrome. She has had multiple MRI’s including lower extremity, back, and brain, two angio’s, two popliteal releases (all normal), as well as pressure measurements of the calf compartments (borderline normal) and everyone just scratches their head and says if you find out what it is please let us know. I am a physician, and I have no clue that hasn’t been thought of, but she is clearly not the first person in the world to have this and someone, somewhere knows what it is, they just don’t know her. Any recommendations on where to post this to get the most cogent responses?
There is a small probability that there is a web site(s) concerned with such conditions. Finding it may be difficult. BBS’s likewise.
Best wishes for success.
How old is she? Is she an athlete or avid bicyclist?
As you probably know, psoas hypertrophy in female athletes, especially cyclists, can cause claudication. But I think that would show up on the angio, no?
Does she have migraines? And use ergot preparations? Still, I’m pretty sure ergot-induced fibrosis would also be seen on angiography.
In the presence of a normal angiogram and normal MRIs, it is difficult to conceive of any cause. Could there be dynamic entrapment of a vessel during exercise? Has she had dopplers done during or immediately after exercise?
I guess I would also wonder whether there’s an equivalent to “subclavian steal” in the leg?
She is 16 years old. She WAS a very avid runner and swimmer. Now does it much less because of the pain. The pain starts as burning with the calf muscles and goes on to a throbbing, cramping pain. She is not on any medications and takes no ellicit drugs that I know of. Psoas hypertrophy would have shown up on either or both of the MRI’s and body CT, and probably the angio. Muscle biopsy was negative as well. I will ask her about dopplers after exercise. I know that many of the studies were done after she excercised to symptoms, but am not sure which ones, and don’t even know all the studies that were done.