What condition is indicated by intermittent claudication and a weak popliteal pulse with knee extension?

Intermittent claudication accompanied by a weak popliteal pulse during knee extension is suggestive of popliteal artery entrapment syndrome. This condition occurs when the popliteal artery is compressed due to abnormal anatomical relationships with surrounding structures, particularly the gastrocnemius muscle or other soft tissues, during specific movements of the knee and foot, such as extension.

Patients often report pain in the calf (intermittent claudication), which is a hallmark of arterial insufficiency. The weak pulse is indicative of compromised blood flow due to this entrapment, particularly in positions that exacerbate the compression. The condition can lead to ischaemia and may present more severely during activities that involve repetitive knee extension.

In contrast, other options like deep vein thrombosis (DVT), sciatica, and adductor canal compression syndrome do not typically present with the combination of intermittent claudication and a weak pulse that is worsened by knee extension. DVT primarily involves venous thrombosis leading to swelling and pain but usually does not affect arterial pulses. Sciatica refers to nerve pain that follows the pathway of the sciatic nerve, which is not directly related to peripheral vascular compression. Adductor canal compression syndrome involves vascular and nerve