We studied 117 patients with a chief complaint of intermittent claudication to define the frequency and the differential diagnosis of lumbar spinal canal stenosis (LSCS) and peripheral arterial occlusive disease (PAOD). The patients were classified into three groups: Group 1: LSCS, Group 2: PAOD and Group 3: patients with LSCS and PAOD after lumbar MRI (or myelography) and MRA of the lower limbs was performed in all patients. Thirty patients (25.6%) had vascular disease (PAOD=13, coexistence=17). Effective physiological findings for differential diagnosis were a standing endurance test, postural factors, the pulse of dorsalis pedis artery, and calf pain. The ABPI was highly useful for detecting PAOD patients. Given that approximately a quarter of patients presenting intermittent claudication had PAOD, orthopedists need to diagnose PAOD patients as a primary doctor of intermittent claudication.
