Buerger's disease other imaging findings: Difference between revisions
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===Angiogram=== | ===Angiogram=== | ||
This test can detect early signs of vessel damage and help the doctor know the condition of your arteries. During the procedure, the dye is injected into an artery and then take X-rays image. On images, patients with buerger's disease may show signs of blockages in the artery. | This test can detect early signs of vessel damage and help the doctor know the condition of your arteries. During the procedure, the dye is injected into an artery and then take X-rays image. On images, patients with buerger's disease may show signs of blockages in the artery. | ||
DIAGNOSIS — Thromboangiitis obliterans is a predominantly clinical diagnosis that should be suspected in young patients who smoke and who present with ischemia of the hands and/or feet. However, the diagnosis of thromboangiitis obliterans may be a diagnosis of exclusion after ruling out other more common entities which may produce similar clinical symptoms. Biopsy provides a definitive diagnosis, but subcutaneous nodules are not always present. A clinical diagnosis can be established based upon a scoring system using clinical, angiographic, histopathological, and exclusionary criteria [5,62]. | |||
Thromboangiitis obliterans is differentiated from other entities that cause vascular occlusive disease (table 1), the most common of which are discussed below: | |||
●Atherosclerotic peripheral artery disease – The distal nature of thromboangiitis obliterans and involvement of the lower and upper extremities helps to distinguish the disorder from atherosclerosis. Other risk factors for peripheral artery disease, such as hypertension and hypercholesterolemia, may be absent. In the absence of a histological diagnosis of the acute phase lesion, a diagnosis of diabetes mellitus excludes thromboangiitis obliterans. | |||
●Thromboembolic disease – Patients with thromboangiitis obliterans will not have a proximal source for embolism (cardiac, aneurysmal disease) or laboratory evidence of a thrombophilia, though anticardiolipin antibodies may be present. | |||
●Vasculitis – Although distal vessel involvement causes distal ischemia in other vasculitides, serologic markers are negative in thromboangiitis obliterans. | |||
●Repetitive trauma – These patients have an occupational history (eg, jackhammer operator) to suggest the mechanism of small vessel disease. | |||
Clinical criteria — A clinical diagnosis can be established with the following commonly used criteria [55,56,63]: | |||
●Age less than 45 years | |||
●Current or recent history of tobacco use | |||
●Distal extremity ischemia (objectively noted on vascular testing) (See 'Vascular evaluation' above.) | |||
●Typical arteriographic findings of thromboangiitis obliterans (See 'Imaging studies' above.) | |||
●Exclusion of autoimmune disease, thrombophilia, diabetes, and proximal embolic sources (table 1) | |||
Revision as of 13:54, 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]
Other Imaging Findings
Overview
There are no other imaging findings associated with [disease name].
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
- There are no other imaging findings associated with [disease name].
- [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]
- [Finding 3]
Angiogram
This test can detect early signs of vessel damage and help the doctor know the condition of your arteries. During the procedure, the dye is injected into an artery and then take X-rays image. On images, patients with buerger's disease may show signs of blockages in the artery.
DIAGNOSIS — Thromboangiitis obliterans is a predominantly clinical diagnosis that should be suspected in young patients who smoke and who present with ischemia of the hands and/or feet. However, the diagnosis of thromboangiitis obliterans may be a diagnosis of exclusion after ruling out other more common entities which may produce similar clinical symptoms. Biopsy provides a definitive diagnosis, but subcutaneous nodules are not always present. A clinical diagnosis can be established based upon a scoring system using clinical, angiographic, histopathological, and exclusionary criteria [5,62].
Thromboangiitis obliterans is differentiated from other entities that cause vascular occlusive disease (table 1), the most common of which are discussed below:
●Atherosclerotic peripheral artery disease – The distal nature of thromboangiitis obliterans and involvement of the lower and upper extremities helps to distinguish the disorder from atherosclerosis. Other risk factors for peripheral artery disease, such as hypertension and hypercholesterolemia, may be absent. In the absence of a histological diagnosis of the acute phase lesion, a diagnosis of diabetes mellitus excludes thromboangiitis obliterans.
●Thromboembolic disease – Patients with thromboangiitis obliterans will not have a proximal source for embolism (cardiac, aneurysmal disease) or laboratory evidence of a thrombophilia, though anticardiolipin antibodies may be present.
●Vasculitis – Although distal vessel involvement causes distal ischemia in other vasculitides, serologic markers are negative in thromboangiitis obliterans.
●Repetitive trauma – These patients have an occupational history (eg, jackhammer operator) to suggest the mechanism of small vessel disease.
Clinical criteria — A clinical diagnosis can be established with the following commonly used criteria [55,56,63]:
●Age less than 45 years
●Current or recent history of tobacco use
●Distal extremity ischemia (objectively noted on vascular testing) (See 'Vascular evaluation' above.)
●Typical arteriographic findings of thromboangiitis obliterans (See 'Imaging studies' above.)
●Exclusion of autoimmune disease, thrombophilia, diabetes, and proximal embolic sources (table 1)