peripheral vascular disease (ABI , FONTINE)

ankle /brachial pressure is index used to determine vascular disease 

it have many value 

>1.4 = calcification-vessel hardening = refer to vascular specialist 

1-1.4=normal = no need to refer 

0.9-1=acceptable = no need to refer 

0.8-0.9=some arterial disease =treat risk factor 

0.5-0.8=moderate arterial disease  =refer to vascular specialist 

<0.5 = severe arterial disease = refer to vascular specialist 


according to leg ischemia , there is fontine classification 

I : asymptomatic 

IIa: mild claudication 

IIb: moderate-severe claudication

III: ischemic rest pain 

IV: ulceration or gangrene


so if patient present to you with leg pain you should cover this points in the history

1-is claudication severe(make patient can't keep walking) or mild(II) 

2-is there rest pain (III)

3-by examination , is there ulceration-gangrene(IV)

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