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


METHODS
Cross sectional, observational study conducted at 96 internal medicine services.


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.
Manzano
Luis
L
Heart Failure and Vascular Risk Unit, Hospital Ramón y Cajal, Universidad de Alcalá, Madrid, Spain. luis.manzano@uah.es
García-Díaz
Juan de D
Jde D
Suárez
Carmen
C
Mostaza
José Ma
JM
Cairols
Marc
M
González-Sarmiento
Enrique
E
Rojas
Alipio Mangas
AM
Vieitez
Paula
P
Sánchez-Zamorano
Miguel Angel
MA
Zamora
Javier
J
D000368:Aged; D000465:Algorithms; D002081:Buttocks; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007383:Intermittent Claudication / Q000175:diagnosis / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000175:diagnosis* / Q000453:epidemiology*; D016491:Peripheral Vascular Diseases / Q000175:diagnosis* / Q000453:epidemiology*; D011237:Predictive Value of Tests; D015995:Prevalence; D012307:Risk Factors; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires; D013848:Thigh