Presentation
Right leg swollen during last 40 days, painful, elevated D-dimer levels.
Patient Data
Patient presented with a swollen right leg. Difference in calf circumference was 7 cm.
Transverse view of distal upper leg shows a hypoechoic formation with a slow flow inside.
The observed movement pattern, i.e. turbulent forward and backwards flow, is the yin-yang sign characteristic for a pseudoaneurysm. High velocities in the proximal part of the lesion are characteristic for the neck of pseudoaneurysm. In the popliteal artery and vein distal to the pseudoaneurysm, no flow was detected. In the calf arteries, collateral waveforms were observed, if flow was detectable.
Case Discussion
The patient presented with swollen right leg caused by flow obstruction from a large pseudoaneurysm of the distal superficial femoral artery, which compressed the popliteal artery and vein.