Peripheral vesicular disease,”Intermittent claudication (leg cramp occurs after walking the distance). Relieved by restIf severe, pain at rest (in these patients, they wake up at night from the pain and get relief by hanging leg off the bed)Look for reduced pulse, muscular atrophy, thick toenails, ulcers of the toesDx: Arteriography > ABI (systolic BP ankle to the arm)ABI: 0.9 – 1.3: NormalABI: <0.9 indicates PVD*Patients with DM have calcifications, falsely raising their ABITreatment: Stop smoking, cilostazol (vasodilator)

Peripheral vesicular disease,”Intermittent claudication (leg cramp occurs after walking the distance). Relieved by restIf severe, pain at rest (in these patients, they wake up at night from the pain and get relief by hanging leg off the bed)Look for reduced pulse, muscular atrophy, thick toenails, ulcers of the toesDx: Arteriography > ABI (systolic BP ankle to the arm)ABI: 0.9 – 1.3: NormalABI: <0.9 indicates PVD*Patients with DM have calcifications, falsely raising their ABITreatment: Stop smoking, cilostazol (vasodilator) surgery for rest pain”