A 65-year-old man presents with progressive bilateral leg pain on walking that resolves with sitting or leaning forward. Neurological examination is normal at rest. MRI shows severe central canal stenosis at L3-L4 with compression of the thecal sac. What is the most appropriate term for this clinical presentation?
- A Vascular claudication
- B Neurogenic claudication ✓
- C Sciatica
- D Rest pain
Correct answer: B. Neurogenic claudication
Explanation
Neurogenic claudication is caused by lumbar spinal stenosis. It presents with bilateral leg pain, numbness, or weakness triggered by walking or standing and relieved by sitting or forward flexion (which increases canal diameter). It is distinguished from vascular claudication by the relief with spinal flexion and preserved peripheral pulses. Vascular claudication is relieved by standing still. Sciatica is radicular pain in a dermatomal distribution. Rest pain occurs in critical limb ischemia.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
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Written and medically reviewed by the StethoPrep medical team.