Buttock claudication: what induces pain only in the left buttock on every movement?

摘要

An 89-year-old man presented with a 3-day history of pain in the left buttock with every movement. He felt pain whenever he moved, including when standing up or walking. Although this prevented him from walking, the pain disappeared at rest. He had a history of arteriosclerotic diseases including arteriosclerosis obliterans and cerebral infarction, but he had no history of trauma. He had undergone pacemaker implantation to treat a complete atrioventricular block. Physical examination revealed no tenderness or skin lesions in the left buttock and no signs of nerve root compression. Laboratory examination revealed an elevated D-dimer concentration of 1.24 µg/mL. A plain pelvic radiograph showed no findings of osteoarthritis or bone fractures. Therefore, we performed CT with contrast enhancement to identify vascular abnormalities, especially around his left buttock.