A 57-Year-Old Man With Difficulty Walking

Stephen Johnson, MD, MS; Michael Furman, MD, MS


September 16, 2015

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A 57-year-old man presents to his primary care provider with gradually worsening lower-extremity pain and fatigue with ambulation. He is able to walk one block and then must sit down and rest owing to "tiredness" in his legs. He has intermittent low back pain, which rarely radiates into his left anterior thigh.

His medical history includes type 1 diabetes mellitus, hypertension, and chronic obstructive pulmonary disease. Current medications include insulin glargine (Lantus®), lisinopril (Zestril®), aspirin (Bayer®), and a fluticasone propionate inhaler (Flovent®). He smokes one pack of cigarettes per day, with a 20–pack-year history. He does not drink alcohol or use illicit drugs.


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