Diagnostic Clues

1) When pallor, decrease in temperature, and numbness are the only complaints, viability of the limb usually not threatened. A condition of pain, pallor, and paralysis indicates threatened limb viability.

2) Sensation of numbness and decrease in temperature indicates a probability of insufficient collateral circulation to maintain limb viability.

3) A bruit is frequently heard when an arterial plaque or aneurysm is present.

4) Rest pain in the digits and forefoot indicates marginal arterial flow.

5) Claudication pain is more severe and walking distance is shortened when patient is climbing stairs and hills.

6) Claudication does not occur with occlusions in the anterior tibial, posterior tibial, or peroneal arteries.

7) The combination of hip, thigh, and buttock claudication with impotence in the male is indicative of terminal aortic occlusion known as Leriche's syndrome.

8) Symptoms occurring at rest are the result of either multiple levels of occlusion or disease or a critical arterial segment including major collaterals.

9) Patients with..co-existing diabetes mellitus present with variations of symptomatology, much of it resulting form existing peripheral neuropathies.