Professional Practice Guide -FCSV-EN

12 3. Evaluating Peripheral Artery Disease (PAD) 3.1 MEDICAL HISTORY AND PHYSICAL EXAMINATION The Edinburgh Questionnaire (Table 1) helps establish a diagnosis of PAD in patients presenting with claudication and differentiate it from claudication of nonvascular origin. Neurogenic pseudoclaudication is the most common differential diagnosis. Table 2 helps distinguish between these two conditions. The next step is to determine disease severity using the Leriche and Fontaine classification (Table 4). On physical examination (Table 3), PAD assessment should include palpation of the femoral, popliteal, anterior tibial, and dorsalis pedis pulses, as well as the radial and ulnar pulses, palpation of the abdominal aorta to assess for an aneurysm, auscultation of the groin folds, the periumbilical region, arterial bifurcations, supraclavicular fossae, and the renal arteries to detect vascular bruits. The combination of palpation and auscultation has good sensitivity and specificity for the detection of PAD.¹ Aorta Iliac Radial Femoral Popliteal Tibial Dorsalis pedis Ulnar pulse Ӌ TABLE 3. Ӌ ANATOMICAL DIAGRAM Professional Practice Guide