59 year old male with short distance exercise induced left leg pain. Pain was severe and was interferring with the patients actively living. He was seen and treated for neurogenic claudication for several months without any improvement. The patient had palpable pulses in the left foot which was mistaken as indicating he had good blood flow to the leg. There is a common misconception that pulses in the foot means that there is no significant peripheral arterial disease. All patients with exertional leg pain (pain when walking) need to be evaluated with an exercise ankle brachial index study (ABI). In 1 hour, the patient was treated and was able to resume referring soccer games 48 hours later.
Nutcracker syndrome is one of the causes of secondary pelvic congestion syndrome.
Presentation at Charring Cross Meeting London 2015
Painful varicoceles interfering with high school athletics