Intermittent claudication

(A) Most common in calf region# INTERMITTENT CLAUDICATION:> Cramp like pain felt in the muscles that is brought on by walking, not present on taking the first step (OA) relieved by standing still (IVD)> The distance walked is called the claudication distance.> Most commonly felt in the CALF, but can affect the thigh or the buttock.> Less common in the upper limb (writhing or manual labor).CLINICAL SPECTRUM OF CLAUDICATIONIntermittent(Atherosclerosis)Neurogenic(Lumbar Spinal Stenosis)Venous(Deep Vein Thrombosis)* Pain is in the muscle of the calf, thigh or buttock* Pain is in whole leg can be associated with tingling and numbness* Involvement of whole leg* Unilateral in femoropopliteal disease* Bilateral (Can also be less commonly unilateral)* Patient may describe feeling their "leg is going to burst"* Bilateral in aorto-iliac disease* Comes on suddenly on standing up or walking* Most commonly unilateral* Gradual onset after walking "claudication distance"* Relieved by sitting down, bending over and stop walking* Gradual onset after beginning to walk* Pain is relieved by rest* Unable to straighten legs* Relief on elevating the leg* Absent/reduced pulses * Cyanosed* Varicose veins* edematousNB, The claudication distance is a constant distance the patient was able to walk before the onset of symptoms