Do I have peripheral artery disease?

Question

Hello doctor,

I am a 33-year-old female. I do not smoke, am not overweight, and do not have diabetes. For the past six months, I have had pain in my left calf, ankle, and groin, which caused me to limp. Recently, the pain returned after a pedicure massage.

I also notice my left foot and lower leg feel cold at night, though both legs are normal by morning. I sometimes get pain radiating from my buttock down my left leg, like sciatica.

Tests done:

Emergency venous Doppler ultrasound: Normal.
D-dimer: Negative (recently repeated 3 weeks ago).
MRI left ankle: Talofibular ligament sprain.
Arterial Doppler ultrasound: Decreased flow in the left anterior tibial artery, increased peak systolic velocity in the left common femoral artery; no stenosis, sclerosis, or plaque.

Additional info:

LDL slightly high, HDL high.
I have a 4-hour flight next week and am worried about safety.

I want to know the following:

Could the ankle sprain have caused the temporary decreased arterial flow?
Could this be peripheral artery disease or a blood clot?
Is flying safe in my condition?
Can arterial Doppler or D-dimer detect arterial clots, or is D-dimer only for veins?

I have attached all my reports for your reference. Please advise.

Thank you.

Answer 1

Hi,

Welcome to icliniq.com

I read your query and can understand your concern.

From what you have described, it seems your first episode of left leg pain was caused by your ankle sprain (talofibular ligament), which had healed. The pain you are experiencing now is most likely related to a similar issue.

At 33, as a non-smoker, it is very unlikely that you have peripheral artery disease. The decreased blood flow seen on your arterial Doppler could have been a temporary vessel spasm, not a disease. No clot or signs of vascular disease were found.

You can safely take your upcoming flight, so there is no need to worry.

Important points for you:

Arterial Doppler can detect clots in arteries; D-dimer is only useful for veins.
Check if your footwear or repeated strain on your ankle could be causing recurrent sprains.

I suggest seeing an orthopedic doctor to confirm if the ankle is the cause. If everything looks normal but the pain continues, a vascular surgeon can evaluate further, but that may not be necessary.

Take care and try to avoid putting extra strain on your ankle for now.

I hope this helps.

Kindly revert so I can assist you further.

Thank you.

Answer 2

Hi,

Welcome back to icliniq.com.

I read your query and can understand your concern.

There is nothing significant in your report (attachments removed to protect the patient's privacy) that should worry you. The increased flow in your left common femoral artery is just an incidental finding; it simply means there was a mild difference compared to the right side. Since no stenosis (narrowing) or blockage was seen, there is no cause for concern.

I understand how reading information online can increase anxiety, especially when medical terms sound serious. Please do not worry, your test results are overall reassuring.

The cold feeling in your left foot and leg could also be due to a nerve-related issue, especially since you mentioned pain radiating from your buttock down the leg. If this discomfort continues, it would be worth checking with your doctor for possible nerve compression or irritation.

You do not need another arterial Doppler before your flight; a clot is very unlikely in your case.

For your understanding:

Arterial clots cause sudden, severe pain, redness, and coldness in the limb; they present as emergencies.
Venous clots usually develop slowly, causing gradual swelling, mild pain, and sometimes low-grade fever.

So, please do not worry, your symptoms and reports do not suggest anything serious. Take care, and have a safe flight.

I hope this helps.

Kindly revert in case of further queries.

Thank you.