Alex Maxwell
67, Male
You request the outpatient investigations for review at the next consultation.
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Intermittent claudication:
This is defined as :
The pain in a muscle (usually the calf) that occurs due to arterial insufficiency and is reproducible as a result of exercise and is relieved by rest.
It can be categorised using the Fontaine and Rutherford Classification.
Fontaine Classification Rutherford Classification Stage Symptoms Grade Category Symptoms I Asymptomatic <=> 0 0 Asymptomatic II IIa Non-disabling intermittent claudication <=> I 1 Mild claudication I 2 Moderate claudication IIb Disabling intermittent claudication I 3 Severe claudication III Ischaemic rest pain <=> II 4 Ischaemic rest pain IV Ulceration or gangrene <=> III 5 Minor tissue loss III 6 Major tissue loss -
This can be differentiated from critical limb ischaemia which is defined by the European society of vascular surgery as:
- persistently recurring ischemic rest pain requiring regular adequate analgesia for more than two weeks with an ankle systolic pressure ≤ 50 mmHg and/or toe systolic pressure ≤ 30 mmHg;
- ulceration or gangrene of the foot or toes, with an ankle systolic pressure ≤50 mmHg or toe systolic pressure ≤ 30 mmHg.