Spinal claudication versus arterial claudication

Maher, Michael M.; Hehir, D. J.; Neary, Peter; Hinchion, John; O’Donnell, J. A.

doi:10.1007/bf02943798

Cited by 6 publications

(6 citation statements)

References 11 publications

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“…Spinal claudication is an important differential diagnosis of intermittent claudication, especially in cases without gangrene. [19][20][21][22] In our study, out of 15 patients with clinical suspicion of intermittent claudication, three patients had normal duplex scans and were later diagnosed with spinal claudication. In one study, spinal claudication was diagnosed in 13 out of 31 patients with suspected intermittent claudication.…”

Section: Discussionmentioning

confidence: 99%

Correlation of Duplex Scan and Clinical Profile of Peripheral Vascular Diseases In Dmch

Abedin,

Afzalul Haque,

Shamsuzzaman

2023

J Dhaka Med Coll

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Background: Duplex ultrasound is a non-invasive evaluation of blood flow in the major arteries and veins. It provides a unique spectrum of details, including the anatomical location of the lesion, accompanied by further information about flow velocity and volume. Day by day, this investigation has become popular among physicians and surgeons to evaluate peripheral arterial disease. Objective: To determine duplex scans’ accuracy in diagnosing peripheral arterial disease and correlate it with clinical diagnosis. Materials & Methods: The cross-sectional study was conducted in the Department of General Surgery in collaboration with the Department of Radiology & Imaging, Dhaka Medical College Hospital, and Dhaka from January 2011 to December 2011. A total of 100 clinically diagnosed cases of peripheral arterial disease, irrespective of age and sex, were included in the study. However, emergency cases of peripheral arterial disease and patients of peripheral arterial disease with concomitant cerebrovascular disease or venous pathology or arterio-venous malformation were excluded from the study. Based on clinical signs and symptoms, a clinical diagnosis was made, correlated with the diagnosis made by duplex scan findings. Result: Peripheral arterial disease was mainly confined to the lower limb (85%). The right limb was involved in about two-thirds (64%) of the cases, the left limb in 31%, and both limbs in 5% of cases. More than 90% were a smoker. Pain and intermittent claudication were the universal complaints of the patients, followed by hair changes (85%), colour changes (86%) and wasting of the limb (65%). The most commonly involved arteries in the lower limb were arteria dorsalis pedis (96.6%), followed by the posterior tibial artery (84.2%), popliteal artery (60.6%), and femoral artery (21.3%). In the upper limb, the radial artery was involved in 100% of cases and the brachial artery in 86.7% of cases. Endarteritis obliterans and atherosclerosis were common clinical diagnoses (47% and 48%, respectively). Diagnosis based on duplex scan findings also demonstrated that endarteritis obliterans and atherosclerosis were common (40% and 39%, respectively), bearing consistency with clinical diagnosis. The strength of agreement between the two diagnoses was moderate (k = 0.743). Conclusion: The study concludes that there was a moderate agreement between Clinical diagnosis and duplex diagnosis, which indicates that a duplex scan can be a valuable tool to support clinical diagnosis, suggest other diagnoses, or detect other associated pathologies. J Dhaka Med Coll. 2022; 31(1) : 98-106

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Section: Discussionmentioning

confidence: 99%

Correlation of Duplex Scan and Clinical Profile of Peripheral Vascular Diseases In Dmch

Abedin,

Afzalul Haque,

Shamsuzzaman

2023

J Dhaka Med Coll

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“…Leg pain on walking is a common symptom in patients presenting to the vascular clinic but is not always due to vascular disease. Intermittent claudication was first described by Charcot in 1858 3 and is defined as 'pain caused by exercise and relieved by rest' .4-' It affects 10% of the population over 70 years and 2% of those aged 37-69 years. 5 • 6 Warren identified two criteria for diagnosing intermittent claudication.…”

Section: Discussionmentioning

confidence: 99%

Non‐vascular Claudication: A Clinical Conundrum

Fasih

Pickin

Cuschieri

2003

Int J Clinical Practice

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SUMMARYThis is a prospective study of patients referred to our department with symptoms of claudication unlikely to be of vascular origin. After clinical assessment these patients were referred to an orthopaedic physician. Of 1070 patients referred, 33 patients were diagnosed with a non‐vascular problem. Of these, 21 were cases of spinal stenosis with or without nerve root irritation, seven had a combination of spinal pathology and peripheral vascular disease, and five were diagnosed with intervertebral disc prolapse (n=3), diabetic neuropathy (n=1) and chronic fatigue syndrome (n=1). The prognosis for patients with non‐vascular claudication in respect of the development of premature vascular events is likely to be different from vascular claudicants and they should be counselled appropriately Furthermore, the potentially less favourable outcome following reconstruction must be clearly explained to patients with a non‐vascular contribution to their symptoms before any therapeutic vascular intervention. Failure to do this is likely to have significant medicolegal implications.

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“…3,4 Symptoms related to occlusive vascular lesions of the lower limbs range from intermittent claudication to pain at rest. 5 Narrowing or occlusion of arteries of the lower limbs may produce pain in the buttocks, thighs, and legs. 6 Thus these symptoms of vascular lesions may be confused with those of lumbar radiculopathy.…”

Section: Introductionmentioning

confidence: 99%

“…6 Thus these symptoms of vascular lesions may be confused with those of lumbar radiculopathy. 3,5,7 A spine surgeon may overlook occlusive arterial disease of the legs in patients with lumbar degenerative disease including central canal stenosis, foraminal stenosis, and spondylolisthesis. Although the incidence of vascular claudication is very low, overlooking occlusive vascular lesions can lead to unnecessary spine surgery.…”

Section: Introductionmentioning

confidence: 99%

Concomitant Occlusive Vascular Lesions of Legs in Patients with Degenerative Lumbar Diseases: Do These Lesions Influence Treatment?

Lee

Heo

Cho

2018

J Neurol Surg A Cent Eur Neurosurg

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If patients present with a weak or absent dorsalis pedis artery pulse, abnormal ABPI ratio, and no response after a pain-blocking procedure, the clinician should consider the possibility of severe arterial occlusion of the legs. We suggest that the differential diagnosis of obstructive arterial lesions of the legs from lumbar degenerative diseases is important to prevent unnecessary invasive surgical treatment of the lumbar spine.

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Spinal claudication versus arterial claudication

Cited by 6 publications

References 11 publications

Correlation of Duplex Scan and Clinical Profile of Peripheral Vascular Diseases In Dmch

Correlation of Duplex Scan and Clinical Profile of Peripheral Vascular Diseases In Dmch

Non‐vascular Claudication: A Clinical Conundrum

Concomitant Occlusive Vascular Lesions of Legs in Patients with Degenerative Lumbar Diseases: Do These Lesions Influence Treatment?

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