The cause of exertion-induced pain in the extremities may, in addition to arteriopathies, be diseases of the veins, neuralgia, neurological or degenerative diseases and inflammatory joint changes.
  • Thromboangiitis obliterans
  • Disturbances of venous blood drainage

    Ø  Pain is reduced when the extremity is elevated.

  • Stenoses in the region of the lumbar vertebral canal, intervertebral disk prolapses, tumors or metastases.

    Ø  The pain symptoms usually affect both legs and patients often also complain of back pains. Symptoms often improve if the affected leg is bent at the hip joint, back pain also frequent when lying down.

  • Spinal circulation disturbances

    Ø  Typical tension pains and a feeling of heaviness in the affected extremity, and possibly symptoms of lameness occur

  • Degenerative joint diseases

    Ø  The main features are exertion-induced joint pains and possibly deformity.

  • Funicular myelosis with weak legs in the presence of vitamin B12 deficiency

    Ø  Patients have disturbed deep sensibility and often also a positive Babinski reflex and no proprioceptive muscle reflexes.


Since 65% of all patients with PAD also have neurological and orthopedic diseases superimposed on the symptoms of PAD or simulating a symptomatic stage in the asymptomatic stages, neurological and orthopedic examinations should be performed where there is a discrepancy between symptoms and examination results.

Memo:

Vascular calcifications which show up in X-rays without symptoms of PAD being present may be deposits in the medial layers of the arteries. The diagnosis of medial sclerosis is confirmed if obstacles to arterial flow can be excluded by means of noninvasive examination methods. Estimated arterial blood pressure is typically too high in medial sclerosis