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Diagnosis of neurogenic claudication is based on typical clinical features, the physical exam, and findings of spinal stenosis on computer tomography (CT) or X-ray imaging. [1] In addition to vascular claudication, diseases affecting the spine and musculoskeletal system should be considered in the differential diagnosis. [9]
Angiograms of a patient diagnosed with popliteal artery entrapment syndrome of the left lower extremity. Image A shows a neutral popliteal artery before provocative maneuvers. Images B and C show the obstruction (orange arrows) enhanced with provocative maneuvers of plantar flexion and dorsiflexion, respectively.
The word claudication comes from Latin claudicare 'to limp'. Claudication that appears after a short amount of walking may sometimes be described by US medical professionals by the number of typical city street blocks that the patient can walk before the onset of claudication. Thus, "one-block claudication" appears after walking one block, "two ...
Spinal stenosis is an abnormal narrowing of the spinal canal or neural foramen that results in pressure on the spinal cord or nerve roots. [6] Symptoms may include pain, numbness, or weakness in the arms or legs. [1]
Intermittent claudication is a symptom and is by definition diagnosed by a patient reporting a history of leg pain with walking relieved by rest. However, as other conditions such as sciatica can mimic intermittent claudication, testing is often performed to confirm the diagnosis of peripheral artery disease .
The popliteal fossa is to be examined bilaterally (on both sides) with the knee in a semi-flexed position. In some 60% of cases, the popliteal aneurysm presents as a palpable pulsatile mass at the level of the knee joint. Doppler ultrasonography is the preferred diagnostic method. CT angiography and MR angiography may also be employed. [2]
Vascular claudication can resemble spinal stenosis, and some individuals experience unilateral or bilateral symptoms radiating down the legs rather than true claudication. [7] The first symptoms of stenosis include bouts of low back pain. After a few months or years, this may progress to claudication.
Formation of pseudoaneurysm and venous thrombosis lead to claudication, pain, acute ischemia, and symptoms of phlebitis. If the tumor is found under a tendon, it can cause pain during movement causing restriction of joint motion. Pain can also occur due to bursal inflammation, swelling or fracture at the base of the tumor stalk.
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