An unusual cause of ischemic claudication: a case report.
A 56-year-old woman with a chief complaint of left lower-extremity numbness was referred by her gynecologist to the physical medicine clinic for workup of presumed lumbosacral radiculopathy. She had no history of low back pain, and her symptoms were elicited only with exercise. Results of her neurologic examination and lumbosacral radiographs were normal. Her medical history was significant for advanced cervical cancer, successfully treated with local surgery followed by high-dose pelvic radiation and chemotherapy 2 years before the current onset of symptoms. Subsequent workup with Doppler and arteriogram studies discovered a 3-cm area of diffuse stenosis of the left external iliac artery for which she was successfully treated with balloon angioplasty. This case presents an unusual cause of left leg claudication secondary to left iliac artery stenosis 2 years after pelvic radiation for cervical cancer and shows the necessity for a detailed evaluation of patients' medical histories.
Division of Physical Medicine and Rehabilitation, Department of Functional Restoration, Stanford University School of Medicine, Stanford, CA, USA. michael.fredericson@stanford.edu
Michael
M
Fredericson
Brandee L
BL
Waite
D000792:Angiography; D000800:Angioplasty, Balloon; D001157:Arterial Occlusive Diseases / Q000150:complications* / Q000175:diagnosis* / Q000628:therapy; D003937:Diagnosis, Differential; D005080:Exercise Test; D005260:Female; D006801:Humans; D007083:Iliac Artery; D007383:Intermittent Claudication / Q000209:etiology*; D007511:Ischemia / Q000209:etiology*; D007866:Leg / Q000098:blood supply*; D008487:Medical History Taking; D008875:Middle Aged; D010808:Physical Examination; D011878:Radiotherapy / Q000009:adverse effects; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000532:radiotherapy