Thigh and buttock exertional pain for the diagnosis of peripheral arterial disease

Abstract Objectives To evaluate the prevalence of both non-calf intermittent claudication (IC) and classic IC in patients with no known atherosclerotic disease, and their accuracy to detect peripheral arterial disease (PAD). Design Cross sectional, observational study conducted at 96 internal medici...

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Bibliographic Details
Published in:European journal of internal medicine 2009-07, Vol.20 (4), p.429-434
Main Authors: Manzano, Luis, García-Díaz, Juan de D, Suárez, Carmen, Mostaza, José Ma, Cairols, Marc, González-Sarmiento, Enrique, Rojas, Alipio Mangas, Vieitez, Paula, Sánchez-Zamorano, Miguel Ángel, Zamora, Javier
Format: Article
Language:English
Subjects:
Aged
Algorithms
Atherosclerosis
Buttocks
Cross-Sectional Studies
Female
Humans
Intermittent Claudication - diagnosis
Intermittent Claudication - epidemiology
Intermittent claudication Ankle-brachial index
Internal Medicine
Male
Middle Aged
Pain - diagnosis
Pain - epidemiology
Peripheral arterial disease
Peripheral Vascular Diseases - diagnosis
Peripheral Vascular Diseases - epidemiology
Predictive Value of Tests
Prevalence
Risk Factors
Sensibility
Sensitivity and Specificity
Specificity
Surveys and Questionnaires
Thigh
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Summary:Abstract Objectives To evaluate the prevalence of both non-calf intermittent claudication (IC) and classic IC in patients with no known atherosclerotic disease, and their accuracy to detect peripheral arterial disease (PAD). Design Cross sectional, observational study conducted at 96 internal medicine services. Materials and methods 1487 outpatients with no known atherosclerotic disease, and either diabetes or a SCORE risk estimation of at least 3% were enrolled. IC was assessed using the Edinburgh Claudication Questionnaire and PAD was confirmed by an ankle-brachial index (ABI) < 0.9. Results Overall, 7.2% met criteria of classic and 5.8% of non-calf IC. PAD was diagnosed in 393 cases (26.4%). In these PAD patients, 17.8% exhibited classic and 13.2% non-calf IC. Both calf and non-calf IC had similar overall accuracy for detecting PAD. Considering both categories as a whole, the sensitivity of IC to predict a low ABI was 31% and the specificity 93%. Conclusions Non-calf IC is comparable to classic IC for the diagnosis of PAD in patients with no known arterial disease. The systematic implementation of Edinburgh Claudication Questionnaire could be a valuable call-to-action to improve clinical evaluation of PAD, bearing in mind that PAD detected by either non-calf or classic IC must be confirmed by ABI testing.
ISSN:0953-6205
1879-0828
DOI:10.1016/j.ejim.2008.12.019