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  • Title: Thigh and buttock exertional pain for the diagnosis of peripheral arterial disease.
    Author: Manzano L, García-Díaz Jde D, Suárez C, Mostaza JM, Cairols M, González-Sarmiento E, Rojas AM, Vieitez P, Sánchez-Zamorano MA, Zamora J, MERITO Study Group.
    Journal: Eur J Intern Med; 2009 Jul; 20(4):429-34. PubMed ID: 19524189.
    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.
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