A Patient has bilateral buttock pain worsened with walking and relieved when sitting down or leaning forward. Symptoms are not relieved by going from walking to standing still upright. What could be the cause of their symptoms?

The correct answer is B. These are the classical symptoms of claudicatio spinalis. In order to be able to differentiate it from vascular claudication, we must remember that the pain does not get better with rest when the patient is standing. However, the pain does get better if they sit down or lean forward. Answer A is wrong because patients with peripheral artery disease do get relief of their symptoms when they stop walking even if they continue to stand upright. Answer C is wrong because we would expect symptoms related to a particular nerve root which usually don’t get better with sitting or leaning forward.