Claudication Classification and external resources ICD-10 I73.9 ICD-9 443.9 DiseasesDB 2777 MeSH D007383
Claudication, literally 'limping' (Latin), is a medical term usually referring to impairment in walking, or pain, discomfort or tiredness in the legs that occurs during walking and is relieved by rest. The perceived level of pain from claudication can be mild to extremely severe. Claudication is most common in the calves but it can also affect the feet, thighs, hips, buttocks, or arms. The word "claudication" comes from the Latin "claudicare" meaning to limp.
Claudication that appears after a short amount of walking may sometimes be described by US medical professionals by the number of typical city street blocks the patient can walk before the onset of claudication. Thus, "one-block claudication" refers to claudication that appears after walking one block, "two-block claudication" appears after walking two blocks, etc.
Intermittent vascular (or arterial) claudication (Latin: claudicatio intermittens) most often refers to cramping pains in the buttock or leg muscles. It is caused by poor circulation of the blood to the affected area. The poor blood flow is often a result of atherosclerotic blockages more proximal to the affected area; individuals with intermittent claudication may have diabetes—often undiagnosed.
Spinal or neurogenic
Spinal or neurogenic claudication is not due to lack of blood supply, but rather it is caused by nerve root compression or stenosis of the spinal canal, usually from a degenerative spine, most often at the "L4-L5" or "L5-S1" level. This may result from many factors, including bulging disc, herniated disc or fragments from previously herniated discs (post-operative), scar tissue from previous surgeries, osteophytes (bone spurs that jut out from the edge of a vertebra into the foramen, the opening through which the nerve root passes). In most cases neurogenic claudication is bilateral, i.e. on both sides, but it can also be present unilaterally.
Vascular (or arterial) claudication typically occurs after activity or ambulation for a distance with resultant vascular insufficiency (lack of blood flow) where the muscular demands of oxygen outweighs the supply. Symptoms are lower extremity cramping. Resting from activity even in a standing position may help relieve the symptoms.
Spinal or neurogenic claudication may be differentiated from arterial claudication based on activity and position. In neurogenic claudication, positional changes lead to increased stenosis (narrowing) of the spinal canal and compression of nerve roots and resultant lower extremity symptoms. Standing and extension of the spine narrows the spinal canal diameter. Sitting and flexion of the spine increases spinal canal diameter. A person with neurogenic claudication will have worsening of leg cramping with standing erect or standing and walking. Symptoms may be relieved by sitting down (flexing the spine) or even by walking while leaning over (flexion of the spine) a shopping cart.
The ability to ride a stationary bike for a prolonged period of time differentiates neurogenic claudication from vascular claudication. Weakness is also a prominent feature of spinal claudication that is not usually present in intermittent claudication.
The prognosis for patients with peripheral vascular disease due to atherosclerosis is poor; patients with intermittent claudication due to atherosclerosis are at increased risk of death from cardiovascular disease (e.g. heart attack), because the same disease that affects the legs is often present in the arteries of the heart.
Pletal is FDA approved for intermittent claudication. Some things to know before use are the following: contraindicated in patient with heart failure, should be taken 30 minutes before or 2 hours after a meal, and improvement of symptoms may not be evident for two to three weeks.
- ^ a b Peripheral Arterial Disease at Merck Manual of Diagnosis and Therapy Professional Edition
- ^ "claudication" at Dorland's Medical Dictionary
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Cardiovascular disease: vascular disease · Circulatory system pathology (I70–I99, 440–456) Arteries, arterioles
Veinsprimarily lower limb (Deep vein thrombosis)abdomen (Hepatic veno-occlusive disease, Budd–Chiari syndrome, May-Thurner syndrome, Portal vein thrombosis, Renal vein thrombosis)Other Arteries or veins Blood pressure
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См. также в других словарях:
claudication — [ klodikasjɔ̃ ] n. f. • XIIIe; lat. claudicatio, de claudus « boiteux » ♦ Littér. Action de boiter. ⇒ boiterie. Méd. Claudication intermittente : irrégularité de la démarche avec sensation de crampe au mollet, due à une insuffisance circulatoire… … Encyclopédie Universelle
Claudication — Clau di*ca tion, n. [L. claudicatio.] A halting or limping. [R.] Tatler. [1913 Webster] … The Collaborative International Dictionary of English
claudication — CLAUDICATION. s. f. Action de boiter … Dictionnaire de l'Académie Française 1798
claudication — 1550s, from L. claudicationem, noun of action from pp. stem of claudicare, from claudus limping, halting, lame. Related: Claudicant; claudicare … Etymology dictionary
claudication — [klô΄di kā′shən] n. [L claudicatio < claudicatus, pp. of claudicare, to limp < claudus, lame] Med. lameness, esp. when caused by an impaired flow of blood to the leg muscles … English World dictionary
Claudication — Le mot claudication est défini par une irrégularité à la marche. Il a pour synonyme la boiterie. Les causes en sont multiples : raccourcissement d un membre inférieur, ankylose, paralysie totale ou partielle d un membre inférieur ou du… … Wikipédia en Français
claudication — Limping, usually referring to intermittent c.. [L. claudicatio, fr. claudico, to limp] intermittent c. a condition caused by ischemia of the muscles; characterized by attacks of lameness and pain, brought on by walking, chiefly in the calf… … Medical dictionary
claudication — noun Etymology: Latin claudication , claudicatio, from claudicare to limp, from claudus lame Date: 15th century the quality or state of being lame ; limping … New Collegiate Dictionary
claudication — /klaw di kay sheuhn/, n. 1. a limp or a lameness. 2. leg weakness associated with circulation difficulties, relieved by rest. [1375 1425; late ME < L claudication (s. of claudicatio), equiv. to claudic(are) to limp (deriv. of claudus lame) +… … Universalium
claudication — (klô di ka sion) s. f. Terme didactique. Action de boiter. HISTORIQUE XVIe s. • La cause de la claudication et de l emaciation est, que l humeur aura jetté l os femoris hors de sa boëtte et lieu naturel, PARÉ XXI, 12. ÉTYMOLOGIE Le latin… … Dictionnaire de la Langue Française d'Émile Littré