Direct and indirect arterial physiologic testing enabled diagnosis of endofibrosis in a 41-year-old elite athlete, highlighting need for thorough evaluation despite normal rest status.
Highlights the importance of utilizing indirect and direct arterial physiologic testing to diagnose endofibrosis in young, healthy athletes presenting with exercise-induced pain.
Endofibrosis is a rare disorder affecting primarily young healthy athletes, often elite cyclists, or runners. In most published cases, the external iliac artery is affected but studies have shown that in some cases, other vessels may become affected as well. Diagnosing these patients often becomes a challenge since most patients are asymptomatic until being subjected to extreme conditions such as intense training or athletic competition. This is a case of a 41-year-old female elite cyclist and runner who presented with pain in her right thigh with heavy exercise. This case illustrates the need to include a full clinical assessment as well as additional testing immediately to avoid delaying care on patients who may get discharged due to their otherwise healthy presentation in normal conditions.
Andrew Bachman (2026) studied this question. Direct and indirect arterial physiologic testing enabled diagnosis of endofibrosis in a 41-year-old elite athlete, highlighting need for thorough evaluation despite normal rest status.