Claudication pain in leg while walking -physiology behind this?/BOYD CLASSIFICATION

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 CLAUDICATION PAIN IN LEG WHILE WALKING 

INTRODUCTION:

  • Claudio means to limp (Latin word)
  • Crampy pain in muscle seen in limbs 
  • Site of pain depends on site of arterial occlusion
Due to arterial occlusion

  • Metabolites -lactic acid
  • Substance p accumulate in muscle and cause pain








common site -calf muscle

  • Pain in foot - block in lower tibial and plantar vessel
  • Pain in calf-block in femoropopliteal site
  • Pain in thigh - block in superficial femoral artery 
  • Pain in buttocks'-block in common iliac -
LERICHE SYNDROME
  • Pain commonly develops when muscles are exercising 
  • During exercise: increase perfusion and increased opening of collateral wash the metabolites away










BOYD CLASSIFICATION:

GRADE 1:

  • Pain after walking distance which pain develop CLAUDICATION DISTANCE 
  • If patient continues to walk pain subsides -metabolites causing pain are washed away in the circulation due to increased blood flow in muscle and also opening of collateral

GRADE2:

  • Pain still persist on continuing walk ,but can walk with effort

GRADE 3 :

  • Patient has to take rest to relieve the pain

NOTE:

  • Claudication is not common in upper limb but can occur during writing /upper limb exercise .



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