Localization
A subdivision is made regarding the location of the vasoconstriction and is divided into three types: Staging (according to Fontaine-Rachev)
- Type | Frequency | Location | Pain | Missing pulses
- Aortoiliac type | 35% | aorta, iliac artery | buttocks, thigh | from the groin
- Femoral type | 50% | femoral artery (A. femoralis), popliteal artery (A. poplitea) | calf | from the popliteal fossa (A. poplitea)
- Peripheral type | 15% | lower leg and foot arteries | sole of the foot | foot pulses (A. dorsalis pedis) (A. tibialis posterior)
- Stage I: No complaints (detectable changes)
- Stage II: Stress pain (intermittent claudication)
- Stage IIa: Painless walking distance >200m
- Stage IIb: Painless walking distance <200m
- Stage III: Pain at rest (critical undersupply)
- Stage IV: Pain at rest, in addition tissue loss (necrosis), black coloration (gangrene), ulcers (ulcer) (critical undersupply)
Other diseases with similar symptoms (differential diagnosis)
However, the symptoms of this disease are by no means absolutely unique, so there are a number of other diseases that need to be considered. For example, orthopaedic diseases of the feet, knees or pelvis can also lead to pain when walking and during exertion. These include, for example, hip arthrosis, knee arthrosis, leg shortening or pelvic obliquity.
Various nerve diseases or damage can also cause pain or even numbness and cold sensations. This is possible in the case of damage to (peripheral) nerves or also in the case of constrictions/incarcerations in the spinal cord, e.g. : It is also possible that instead of the blood flow (through the arteries) the blood outflow (through the veins) is obstructed. This can occur in the context of CVI (chronic venous insufficiency).
This can even lead to ulcers. These can also be caused by injuries (traumas), so that PAVK does not automatically have to be present. Late effects of diabetes mellitus can also lead to nerve damage and even cause pain at rest (diabetic polyneuropathy).
Finally, there are diseases of the connective tissue and systemic diseases (affecting the whole body). This group is very diverse and also includes very rare diseases. (lupus erythematosus, scleroderma, amyloidosis, cryoglobulinemia and many others). – Spinal stenosis of the lumbar spine
- Root irritation syndromes of the lumbar spine
- Slipped disc of the lumbar spine
