This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Web of Science (1) Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Bernstein, J. Articles by Mitchell, M. E Search for Related Content PubMed PubMed Citation Articles by Bernstein, J. Articles by Mitchell, M. E Social Bookmarking                         What's this?

The prevalence of occult peripheral arterial disease among patients referred for orthopedic evaluation of leg pain

Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia, PA, USA; Veterans Affairs Medical Center, Philadelphia, PA, USA

John L Esterhai

Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia, PA, USA; Veterans Affairs Medical Center, Philadelphia, PA, USA

Mitchell Staska

Veterans Affairs Medical Center, Philadelphia, PA, USA

Sally Reinhardt

Veterans Affairs Medical Center, Philadelphia, PA, USA

Marc E Mitchell

Department of Surgery, University of Mississippi, Jackson, MS, USA memitchell{at}surgery.umsmed.edu

Abstract

Lower extremity peripheral arterial disease (PAD) and musculoskeletal conditions both produce symptoms of leg pain, and may coexist. This study assesses the prevalence of PAD among patients referred to orthopedic surgery for evaluation of lower extremity pain. Fifty consecutive patients aged 50 years or more who had a chief complaint of leg pain, no history of trauma, and no previous history of PAD were studied prospectively. The presence of known risk factors for PAD and classic claudication symptoms was assessed by telephone interview and medical record review. Individuals were then evaluated by measurement of the ankle–brachial index (ABI) using Doppler and pulse volume recordings (PVR). A patient was deemed to have PAD if the ABI was below 0.9 or if the PVR demonstrated significant abnormalities. Occult PAD was detected in 10 of the 50 patients (20%) on the basis of the non-invasive vascular studies. There were no differences between patients with PAD and those without PAD regarding the presence of risk factors for PAD. None of the patients without PAD had claudication, while only one of the 10 patients with PAD had symptoms of classic claudication. In conclusion, 20% of patients referred by primary care providers to the orthopedic surgery clinic for lower extremity pain were discovered to have occult PAD. The majority of these patients did not have claudication. Orthopedic surgeons and primary care providers must maintain an appropriately high index of suspicion for PAD when evaluating patients with non-traumatic lower extremity pain.

Key Words: claudication • degenerative joint disease • peripheral artery disease

Vascular Medicine, Vol. 13, No. 3, 235-238 (2008)
DOI: 10.1177/1358863X08091970


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				V. Jaquinandi, G. Mahe, and B. Noury Letter by Jaquinandi et al Regarding Article, "Different Calculations of Ankle-Brachial Index and Their Impact on Cardiovascular Risk Prediction" Circulation, May 12, 2009; 119(18): e527 - e527. [Full Text] [PDF]