Claudicatio

Claudicatio, commonly known as intermittent claudication, is a symptom complex characterized by reproducible pain, cramping, or fatigue in the leg muscles that is provoked by walking or other exertion and relieved by rest. The term derives from Latin claudicatio, meaning limping, and is most often used to describe leg symptoms due to reduced blood flow from peripheral artery disease.

The most frequent cause is atherosclerotic peripheral artery disease (PAD), which narrows or occludes arteries supplying the legs, limiting blood supply during increased demand. Less commonly, claudication-like symptoms can result from non-arterial conditions such as spinal canal stenosis causing neurogenic claudication or other musculoskeletal disorders.

Clinical features typically include the calf as the most commonly affected site, though the thigh or buttock can be involved. Symptoms occur with a reproducible distance or time of walking and are relieved by rest. Rest pain or non-healing ulcers indicate progression toward critical limb ischemia and require urgent assessment.

Diagnosis usually begins with measurement of the ankle-brachial index (ABI), followed by duplex ultrasonography to assess blood flow. If needed, CT or MR angiography can delineate arterial anatomy for potential revascularization. Laboratory tests help evaluate cardiovascular risk factors.

Management focuses on risk factor modification and symptom improvement. This includes smoking cessation, structured supervised exercise programs, and control of lipids, blood pressure, and glucose. Antiplatelet therapy and statins are commonly used to reduce cardiovascular risk. Revascularization, via endovascular interventions or surgical bypass, may be considered for lifestyle-limiting claudication or in cases of critical limb ischemia after maximal medical therapy.