The clinical evaluation of peripheral arterial disease (PAD) is difficult and yet critically important so that patients receive the care they need. The greatest problem is that clinical evaluation is limited in excluding significant PAD. In short, none of the various clinical findings have a high negative predictive value for PAD. Even simple pulse palpation is fraught with error. All patients with non healing ulcers or wounds or with exertional leg pain should undergo objective physiologic testing.
62 year old female with 2 months of short distance claudication and rest pain at night
30 year old female, on oral contraceptives, with severe left leg swelling after a long car ride. Ultrasound showed left iliofemoral DVT.
Nutcracker syndrome is one of the causes of secondary pelvic congestion syndrome.