An unappreciated or unknown symptom: claudication of the buttock

Abstract

Vascular claudication has been described for years as a
calf pain according to the WHO « Rose » criteria.
Nevertheless, in case of aorto-iliac lesions, symptoms
may occur at the level of the back, buttock or hip and
may only be reported as fatigability rather than pain. In
these proximal lesions usual routine investigations may
remain apparently normal leading to prolonged diagnostic erring. Proximal claudication is particularly puzzling
since spine disease (such as lumbar spine stenosis) are
frequently associated to arterial lesions in elderly
patients. Transcutaneous exercise oxymetry appears to be
an alternative tool for the diagnosis of the vascular origin of atypical claudication of claudication of questionable vascular origin. Although not widely used, the technique is available in many vascular investigation
laboratories in France and will shortly be available in few
referral centres abroad.