Welcome to the Podiatry Arena forums

You are currently viewing our podiatry forum as a guest which gives you limited access to view all podiatry discussions and access our other features. By joining our free global community of Podiatrists and other interested foot health care professionals you will have access to post podiatry topics (answer and ask questions), communicate privately with other members, upload content, view attachments, receive a weekly email update of new discussions, access other special features. Registered users do not get displayed the advertisements in posted messages. Registration is fast, simple and absolutely free so please, join our global Podiatry community today!

  1. Everything that you are ever going to want to know about running shoes: Running Shoes Boot Camp Online, for taking it to the next level? See here for more.
    Dismiss Notice
  2. Have you considered the Critical Thinking and Skeptical Boot Camp, for taking it to the next level? See here for more.
    Dismiss Notice
  3. Have you considered the Clinical Biomechanics Boot Camp Online, for taking it to the next level? See here for more.
    Dismiss Notice
Dismiss Notice
Have you considered the Clinical Biomechanics Boot Camp Online, for taking it to the next level? See here for more.
Dismiss Notice
Have you liked us on Facebook to get our updates? Please do. Click here for our Facebook page.
Dismiss Notice
Do you get the weekly newsletter that Podiatry Arena sends out to update everybody? If not, click here to organise this.

Intermittent claudication testing and differential diagnosis

Discussion in 'Diabetic Foot & Wound Management' started by Asher, Jan 19, 2012.

  1. Asher

    Asher Well-Known Member

    Members do not see these Ads. Sign Up.
    Hi all,

    I have a patient who exhibits intermittent claudication-like symptoms. However, I very much doubt it's intermittent claudication. This is due to her age, health status and triphasic pedal waveforms.

    To properly assess exertional leg pain I believe you need to exert (ie: walk) until pain develops and retest.

    My question is, can this be done in an averge podiatry clinic with a doppler and treadmill? And if so, what change in the waveforms constitutes pathology?

    Thanks in advance.

  2. Griff

    Griff Moderator

    Re: Intermittent claudication

    Hi Rebecca,

    I've crudely tested haemodynamics in clinic in the past - not with any level of accuracy or scientific rigor, but just to clarify in my mind what I may have been dealing with and to gather as much information as possible for the potential vascular referral.

    From memory with one chap (cyclist) we tested his ankle-brachial pressure index pre and post exercise --> you gotta be quick once they jump off the turbo-trainer though! Another guy we didn't even bother with the ABPI - post exercise his foot was pale, cold and pulses difficult to palpate (none of which was observed pre-exercise). Not used a doppler as part of the testing personally.

    If its the sort of exercise induced leg pain which looks and smells more like compartment syndrome than anything vascular then those are the ones I refer off for more specialist testing immediately.
  3. Rob Kidd

    Rob Kidd Well-Known Member

    Re: Intermittent claudication

    In my humble non-scientific experience, the vast majority of claudicators smoke. Stop them smoking and some recede. I have seen this more than once. Rob
  4. W J Liggins

    W J Liggins Well-Known Member

    Re: Intermittent claudication

    Is she a continual high heel wearer? If so then that might be your answer, otherwise I go along with Ian's probability of compartment syndrome (of course, the two things are not necessarily mutually exclusive).

    Bill Liggins
  5. footboy25

    footboy25 Member

    Re: Intermittent claudication

    Could it be pseudo-claudication?Ask about his spinal situation;any back surgeries or pain?
  6. drsarbes

    drsarbes Well-Known Member

    Re: Intermittent claudication

    I would suggest you rule out compartment syndrome.
  7. Craig Payne

    Craig Payne Moderator

  8. footboy25

    footboy25 Member

    Re: Intermittent claudication

    Compartment syndrome is plausible.Where is the pain?Anterior or posterior?
  9. Admin2

    Admin2 Administrator Staff Member

  10. Asher

    Asher Well-Known Member

    Thanks everyone,

    Posterior compartment syndrome is very much on the radar and the physio will be referring on for this.

    I was talking to him recently about using doppler to assess arterial supply during diabetic assessment. Following this, he asked me to rule out intermittent claudication in this patient before he refers on, which I have not done before and was a bit stumped.

    Thanks again.

Share This Page