External iliac artery endofibrosis

External iliac artery endofibrosis is an uncommon condition first described in 1984 as an arterial disease affecting competition cyclists. Patients typically present with thigh pain, swelling and numbness occurring during strenuous exercise and subsiding rapidly with rest.1,2 Resected arterial segments displayed a variety of histopathological changes including intimal thickening, medial hypertrophy and inflammation, calcifications, adventitial thickening and luminal thrombi.1,2 There is increasing recognition of this condition as an unusual cause of lower limb pain in athletes, particularly elite cyclists. The published series demonstrate a wide range of pathological appearances, highlighting the need for pathologists to be aware of this entity and its characteristic clinical features, as well as the spectrum of possible histological changes. We report three cases of external iliac artery endofibrosis in cyclists treated at St Vincent’s Hospital.