Iatrogenic pseudoaneurysm is a rare complication of arthroscopic ankle surgery. Duplex ultrasound can be used in diagnosis and management of this condition. We present the case of a 27-year-old woman who presented with painful, pulsatile mass on the right anterior ankle after arthroscopic debridement.
Ultrasound was performed using a Toshiba Aplio 500 with an 11 mHz linear probe and a 6 mHZ curvilinear probe.
Ultrasound showed a 2 cm saccular structure deep to the dorsalis pedis artery with a “yin-yang” pattern on color Doppler consistent with pseudoaneurysm. The patient underwent excision of the pseudoaneurysm with a reverse saphenous vein bypass graft. Recovery was uneventful with patent graft and normal ankle-brachial index on follow up imaging over 18 months.
Iatrogenic pseudoaneurysm is rare, occurring in only 8 per 100,000 cases. In this case, ultrasound provided rapid, inexpensive, non-invasive diagnosis without the use of radiation.
Melinda Bender, University Hospitals of Cleveland