Profunda femoris arteriovenous fistula: clinical and radiological features.

A 61-year-old man presented with a 3-day history of progressive swelling and pain in the right lower limb in September 2010. A motor vehicle injury 39 years earlier had caused a head injury and right femoral shaft fracture, which resulted in a residual right hemiparesis. Subsequently he suffered from recurrent falls and 14 years ago he sustained a right neck of femur fracture, which was surgically fixed with a dynamic hip screw (DHS). However, there was no history of falls in the months prior to the presentation and there was no other significant medical history. Physical examination revealed ecchymosis on the medial aspect of the right thigh associated with significant swelling. There was pitting oedema up to the right knee, but there were no other neurovascular signs. A bruit was audible in the right groin region. An arteriovenous fistula (AVF) was suspected based on these clinical features.