PMC5508493_01
a. Left anterolateral pulsatile swelling 3 cm x 2 cm. Good clinically popliteal, dorsalis pedis and posterior tibial pulses. b. Aneurysmal proximal anterior tibial artery with good proximal doppler signal but slow flow distally into dorsalis pedis.
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Clinical examination revealed a 3 cm x 2 cm fluctuant, pulsatile swelling with no sensory, motor or circulatory deficit (Fig. 1a). A duplex ultrasound was then performed, which suggested a 4 cm x 3 cm pseudo-aneurysm arising from the ATA with trickle of flow distally (Fig. 1b).
Dumbbell shape aneurysm superior to interosseous membrane with anterior and posterior component; Eccentric mural thrombus in the aneurysm with scalloping of the adjacent bones. Yellow Asterisk: False Aneurysm; Orange Arrow: Scalloping of bones; Red Arrow: Mural Thrombus.
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There was good flow distally via the posterior tibial and peroneal arteries (Fig. 2).