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What’s causing this patient’s diminished femoral pulses?

A 56-year-old man presents with a three-month history of erectile dysfunction and bilateral buttock pain on exertion, but not at rest. His past medical history is significant for type 2 diabetes, dyslipidemia, and hypertension. Examination reveals bilaterally diminished femoral pulses. What is the most likely diagnosis?

A. Diabetic amyotrophy
B. Spinal stenosis
C. Leriche syndrome (aortoiliac occlusive disease)
D. Acute aortic thrombosis

Find the answer, discuss this case and more on Figure 1.

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