Case 51-1981: A 55-Year-Old Man with Intermittent Claudication of the Arms

Presentation of Case A 55-year-old man was admitted to the hospital because of intermittent claudication of the arms. He was well until five years earlier, when a diagnosis of diabetes mellitus was made. Dieting resulted in a weight reduction from 90 to 68.2 kg. On a routine annual physical examination 10 weeks before admission the radial and brachial pulses were found to be diminished bilaterally. One month before entry he began to have weakness and pain in both hands and forearms on minor exertion such as tying his necktie, shaving, or completing a single-page government form, with recovery after several.