A 49-year-old man is admitted to the emergency department with a cold and pale foot. Physical examination reveals that the patient suffers from peripheral vascular disease; duplex ultrasound studies indicate possible occlusion of his popliteal artery, and the pulse of the posterior tibial artery is absent. What is the most common location for palpation of the pulse of the posterior tibial artery?

The posterior tibial artery passes under the medial malleolus, about halfway between that bony landmark and the heel, or the calcaneus. The medial edge of the plantar aponeurosis can be palpated just medial to the muscular belly of the abductor hallucis. The sural nerve and the short (lesser) saphenous vein pass around the lateral side of the foot, about halfway between the lateral malleolus and the calcaneus. The sartorius passes behind the medial femoral condyle to insert on the proximal, medial aspect of the tibia via the pes anserinus; usually no pulse can be felt clearly there. The popliteal artery passes between the two heads of the gastrocnemius, where the arterial pulse may be felt very deeply, medial to the midline.