Infection of this areas can occur ( wet gangrene). Gangrene – often black necrotic gangrenous tissue surrounds the punched out ulcer lesions.They are often painful, but diabetic and alcoholic patients may not have pain. These tend to occur after a localised traumatic event. ‘Punched out’ ischaemic ulcers – usually on the toes and heels, rarely higher up the limb.

For more information, see Peripheral Vascular ExamĪn example of a doppler probe used for assessing peripheral pulsesĬan cause claudication / buttock pain at restīurning pain at night, due to elevation (which reduces limb perfusion), and is relieved by hanging the legs over the side of the bed ( very poor prognostic sign!).If you are unable to locate a pulse by hand, you can use a doppler probe to assess if significant blood flow is present in the artery.Absent pulses represent an increased chance of peripheral vascular disease.Palpable pulses indicate low likelihood of peripheral vascular disease.Check the pulse in the foot (posterior tibial and dorsals pedis).There may be evidence of poor skin health due to poor perfusion, such as ulcers, dry scaly skin, cool peripheries and reduced capillary refill time.Elevating the leg may cause it to go pale and cold, as well as causing pain.This also classically causes pain in the back of the legs on exertion.Ĭlaudication comes from the latin “to limp”, which itself derives from the Emperor Claudius – whom it was said walked with a limp Examination The main differential is “spinal claudication” caused by impingement of the caudal equina by a spinal stenosis. in bed), and abate when legs are lowered (e.g. Pain may also occur when legs are raised (e.g.Many patients do NOT present with classic claudication – often because they are not doing enough activity to induce the symptoms – particularly if they have another comorbidity that limits their activity.The pain can occur anywhere along the leg, and down into the foot.This pain is also known as claudication.Pain in the calves on walking, relieved by rest.In the other group of patients it is believed the CAD is masked by PVD, as the PVD prevents patients from exerting themselves to a degree which would initiate symptoms of CAD. About 75% of patients will also have symptomatic CAD. Usually CAD (coronary artery disease) is also present.This file is taken from wikimedia commons and is licensed under the Creative Commons Attribution-Share Alike 3.0 Unported license. Pathology of Peripheral Vascular Disease.

Everdoc alternativen