Detection of Arterial Injury in a Young Athlete via ABI Screening in an Outpatient Physical Therapy Setting: A Case Report

BACKGROUND: Vascular injury is uncommon in young athletes and often mimics musculoskeletal conditions. Delayed diagnosis may result in limb ischemia or long-term morbidity. CASE PRESENTATION: A 21-year-old female collegiate cross-country athlete presented to outpatient physical therapy two weeks after a direct blow to the groin. She reported exertional posterior thigh and calf pain. Ankle-brachial index (ABI) screening using an automatic blood pressure unit revealed abnormal ratios, resulting in referral, imaging, and diagnosis of an intimal dissection of the right common femoral artery. OUTCOME AND FOLLOW-UP: The patient underwent successful endarterectomy and returned to full athletic participation within four months. DISCUSSION: This case illustrates the critical role of physical therapists in recognizing vascular pathology. Automated blood pressure devices provide a pragmatic screening tool in outpatient settings. Broader implementation of ABI testing may improve early recognition of arterial compromise in patients presenting with atypical lower extremity pain.