What You Should Know About Screening For PAD

Author(s): 
Benjamin Sefcik, DPM, and Peter M. Wilusz, DPM

Keys To Screening For Claudication
Claudication is defined as a halt or limp in a person’s walk. Intermittent claudication is defined as pain, tension and weakness in the legs upon walking. This pain intensifies to produce lameness or inability to function, and is predictably relieved by rest. Intermittent claudication is the most common symptom of PAD. At times, it can be difficult to determine true claudication versus disuse in the sedentary patient. This point is arguable in that these symptoms, when present, indicate a potential for PAD whether the person is or is not sedentary.
We feel that the symptoms that present as claudication are significant regardless of the person’s activity level. When posing questions to the patients, it is important to try to determine how much activity it requires to produce the symptoms.
For example, ask patients how far they can typically walk before the discomfort in their legs requires them to stop and rest. This is often a question that patients cannot answer due to the slow development of the disease and the relative collateralization that develops. While the disease is present, in the early stages, it may not produce pain or discomfort, which require rest. A very good question to ask is if patients can still do the same physical activities as they could one, two or three years prior to the development of these symptoms. If they cannot do the same activities, this may be an early clue to their disease process.

Essential Questions To Cover In The Patient History

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