Buerger's disease other diagnostic studies: Difference between revisions

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==Overview==
==Overview==
There are no other imaging findings associated with [disease name].
Biopsy is not routinely performed, however, may be carried out in patients older than 45 years presenting with nodules subcutaneously or migratory thrombophlebitis, with uncharacteristic large artery involvement and/or the presence of higher than normal anticardiolipin antibodies. Biopsy may therefore be helpful in the diagnosis of Buerger's disease. Findings on an biopsy suggestive of Buerger's disease include small and medium vessel involvement, hypercellularity with leukocytic infiltration, segmental affection, occlusion with inflammatory thrombi (may or may not be organized depending on stage of disease), sparing of the internal elastic laminae, formation of microabscesses, and multinucleated giant cells.  
 
OR
 
[Imaging modality] may be helpful in the diagnosis of [disease name]. Findings on an [imaging modality] suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].


==Other Imaging Findings==
==Other Imaging Findings==
*There are no other imaging findings associated with [disease name].
Biopsy is not routinely performed, however, may be carried out in patients that meet the following criteria:<ref name="pmid22285343">{{cite journal |vauthors=Graziani L, Morelli L, Parini F, Franceschini L, Spano P, Calza S, Sigala S |title=Clinical outcome after extended endovascular recanalization in Buerger's disease in 20 consecutive cases |journal=Ann Vasc Surg |volume=26 |issue=3 |pages=387–95 |date=April 2012 |pmid=22285343 |doi=10.1016/j.avsg.2011.08.014 |url=}}</ref><ref name="pmid5431503">{{cite journal |vauthors=Lambeth JT, Yong NK |title=Arteriographic findings in thromboangiitis obliterans with emphasis on femoropopliteal involvement |journal=Am J Roentgenol Radium Ther Nucl Med |volume=109 |issue=3 |pages=553–62 |date=July 1970 |pmid=5431503 |doi= |url=}}</ref><ref name="pmid22784658">{{cite journal |vauthors=Dimmick SJ, Goh AC, Cauzza E, Steinbach LS, Baumgartner I, Stauffer E, Voegelin E, Anderson SE |title=Imaging appearances of Buerger's disease complications in the upper and lower limbs |journal=Clin Radiol |volume=67 |issue=12 |pages=1207–11 |date=December 2012 |pmid=22784658 |doi=10.1016/j.crad.2012.04.005 |url=}}</ref>
 
**Older than 45 years of age
*[Imaging modality] may be helpful in the diagnosis of [disease name]. Findings on an [imaging modality] suggestive of/diagnostic of [disease name] include:
**Nodules subcutaneously or migratory thrombophlebitis
**[Finding 1]
**Uncharacteristic large artery involvement
**[Finding 2]
**Presence of higher than normal anticardiolipin antibodies
**[Finding 3]
*Findings on an biopsy suggestive of Buerger's disease include:
 
**Small and medium vessel involvement
Biopsy — Biopsy is rarely needed but is the only means to establish a definitive diagnosis. Patients with subcutaneous nodules or superficial thrombophlebitis should undergo biopsy. Biopsy is suggested if the patient presents with unusual characteristics such as large artery involvement, age >45 years or the presence of elevated anticardiolipin antibodies. Patients with antiphospholipid syndrome exhibit thrombus without inflammation ruling out a diagnosis of thromboangiitis obliterans [43].
**Hypercellularity with leukocytic infiltration
**Segmental affection
***Normal areas between diseased areas
**Occlusion with inflammatory thrombi
**May or may not be organized depending on stage of disease
**Sparing of the internal elastic laminae
**Formation of microabscesses
**Presence of multinucleated giant cells


If there are no nodules and the patient fulfills the above criteria, a biopsy of an artery or examination of the vein or arteries in an amputated digit or limb may provide a diagnosis; however, this is rarely done.





Revision as of 14:51, 12 April 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Hadeel Maksoud M.D.[2]


Overview

Biopsy is not routinely performed, however, may be carried out in patients older than 45 years presenting with nodules subcutaneously or migratory thrombophlebitis, with uncharacteristic large artery involvement and/or the presence of higher than normal anticardiolipin antibodies. Biopsy may therefore be helpful in the diagnosis of Buerger's disease. Findings on an biopsy suggestive of Buerger's disease include small and medium vessel involvement, hypercellularity with leukocytic infiltration, segmental affection, occlusion with inflammatory thrombi (may or may not be organized depending on stage of disease), sparing of the internal elastic laminae, formation of microabscesses, and multinucleated giant cells.

Other Imaging Findings

Biopsy is not routinely performed, however, may be carried out in patients that meet the following criteria:[1][2][3]

    • Older than 45 years of age
    • Nodules subcutaneously or migratory thrombophlebitis
    • Uncharacteristic large artery involvement
    • Presence of higher than normal anticardiolipin antibodies
  • Findings on an biopsy suggestive of Buerger's disease include:
    • Small and medium vessel involvement
    • Hypercellularity with leukocytic infiltration
    • Segmental affection
      • Normal areas between diseased areas
    • Occlusion with inflammatory thrombi
    • May or may not be organized depending on stage of disease
    • Sparing of the internal elastic laminae
    • Formation of microabscesses
    • Presence of multinucleated giant cells


References

  1. Graziani L, Morelli L, Parini F, Franceschini L, Spano P, Calza S, Sigala S (April 2012). "Clinical outcome after extended endovascular recanalization in Buerger's disease in 20 consecutive cases". Ann Vasc Surg. 26 (3): 387–95. doi:10.1016/j.avsg.2011.08.014. PMID 22285343.
  2. Lambeth JT, Yong NK (July 1970). "Arteriographic findings in thromboangiitis obliterans with emphasis on femoropopliteal involvement". Am J Roentgenol Radium Ther Nucl Med. 109 (3): 553–62. PMID 5431503.
  3. Dimmick SJ, Goh AC, Cauzza E, Steinbach LS, Baumgartner I, Stauffer E, Voegelin E, Anderson SE (December 2012). "Imaging appearances of Buerger's disease complications in the upper and lower limbs". Clin Radiol. 67 (12): 1207–11. doi:10.1016/j.crad.2012.04.005. PMID 22784658.

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