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Understanding leg pain
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Many people dismiss leg pain as a normal sign of aging. You may think it’s arthritis or sciatica or just “stiffness” from getting older. PAD leg pain occurs in the muscles, not the joints. Those with diabetes might confuse PAD pain with a neuropathy, a common diabetic symptom that is a burning or painful discomfort of the feet or thighs. If you are experiencing any kind of recurring pain, talk to your healthcare professional and describe the pain as accurately as possible. If you have any of the risk factors for PAD, you should ask your healthcare professional about PAD even if you are not experiencing symptoms. Diagnosing PAD PAD diagnosis begins with a physical examination. Your doctor will check for weak pulses in the legs. The ankle-brachial index (ABI) test (see illustration on the right) is also usually done. It’s a painless exam that compares the blood pressure in your feet to the blood pressure in your arms to determine how well your blood is flowing. This inexpensive test takes only a few minutes and can be performed by your healthcare professional as part of a routine exam. Normally, the ankle pressure is at least 90% of the arm pressure, but with severe narrowing it may be less than 50%. If an ABI reveals an abnormal ratio between the blood pressure of the ankle and arm, you may need further testing. Your doctor may recommend one of these other tests: Doppler and Ultrasound (Duplex) imaging: a non-invasive method that actually visualizes the artery with sound waves and measures the blood flow in an artery to indicate the presence of a blockage. Computed Tomographic Angiography (CT): a non-invasive test that can show the arteries in your abdomen, pelvis and legs. This test is particularly useful in patients with pacemakers or stents. Magnetic Resonance Angiography (MRA): a non-invasive test that gives information similar to that of a CT without the use of X-rays. Angiography can also be used, but is usually reserved for use in conjunction with treatment. During this test a contrast agent is injected into the artery and X-rays are taken to show arteries of the legs and any blockages that may be present. As stated earlier, PAD often goes undiagnosed. This can be dangerous because PAD can lead to painful symptoms, loss of a leg and/or increased risk of coronary artery disease and carotid atherosclerosis. Because individuals with PAD have this increased risk for heart attack and stroke, the American Heart Association encourages anyone who is at risk to discuss PAD with his or her healthcare professional to ensure early diagnosis and treatment. |
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