Int J Sports Med 2002; 23(5): 322-328
DOI: 10.1055/s-2002-33142
Physiology and Biochemistry
© Georg Thieme Verlag Stuttgart · New York

Recognising Vascular Causes of Leg Complaints in Endurance Athletes. Part 2: The Value of Patient History, Physical Examination, Cycling Exercise Test and Echo-Doppler Examination

G.  Schep1 , M.  H.  M.  Bender1 , S.  L.  Schmikli2 , W.  L.  Mosterd2 , E.  R.  Hammacher3 , M.  Scheltinga1 , P.  F.  F.  Wijn4
  • 1Sint Joseph Hospital, Veldhoven, The Netherlands
  • 2University Medical Centre, Utrecht, The Netherlands
  • 3Sint Antonius Hospital, Nieuwegein, The Netherlands
  • 4University of Technology, Eindhoven, The Netherlands
Further Information

Publication History



Accepted after revision: 25. October 2001

Publication Date:
16 August 2002 (online)

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Abstract

Leg complaints at maximal exercise in endurance athletes may have many causes, including arterial flow limitations in the iliac arteries. Such flow limitations can evolve into serious health problems due to increasing intravascular obstruction or even complete obstruction as a result of dissection or thrombosis. Early detection is therefore of clinical importance, but conventional diagnostic tools often prove inadequate. In the current study simple sports-specific tests are examined for their diagnostic power. Test variables derived from patient history, physical examination, cycling exercise testing followed by arterial pressure measurements at the ankle, and echo-Doppler examination with provocative manoeuvres were tested in 92 symptomatic legs (80 patients). A validated clinical classification acted as a reference. Several test variables proved useful. However, no single test variable combined a high sensitivity with a high specificity. Multivariate testing resulted in the correct classification of 91 % of patients, reaching a sensitivity of 0.90 and specificity of 0.93 (kappa 0.76). Four patients wrongly classified as non-vascular suffered from kinking in the common iliac artery that could not be visualised using the diagnostic tools currently available in this study. In conclusion: simple sports-specific tests accurately diagnose iliac artery obstruction in endurance athletes.

References

G. Schep, MD

Department of Sports Medicine · Sint Joseph Hospital

PO Box 7777 · 5500MB Veldhoven · The Netherlands ·

Phone: +31 (40) 2588217

Email: gschep@sjz.nl