Buerger's disease diagnostic study of choice: Difference between revisions

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Revision as of 17:28, 11 April 2018

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

Overview

Although clinical examination is sufficient for diagnosis, in cases where diagnosis is not definitive, a catheter-based arteriogram is the gold standard test for the diagnosis of Buerger disease. The following result of catheter-based arteriogram is confirmatory of Buerger disease and includes, absence of atherosclerosis, no cause for thromboembolism, small and medium-sized vessels involved, namely tibial, popliteal, and radial arteries, segmental affection of vessels between normal appearing segments and corkscrew collaterals described as collateralization around occlusion area but are not pathognomonic.

Diagnostic Study of Choice

Study of choice

Although clinical examination is sufficient for diagnosis, in cases where diagnosis is not definitive, a catheter-based arteriogram is the gold standard test for the diagnosis of Buerger disease.
The following result of catheter-based arteriogram is confirmatory of Buerger disease:
- Absence of atherosclerosis
- No cause for thromboembolism
- Small and medium-sized vessels involved, namely tibial, popliteal, and radial arteries
- Segmental affection of vessels between normal appearing segments
- Corkscrew collaterals described as collateralization around occlusion area but are not pathognomonic

Sequence of Diagnostic Studies

The catheter-based arteriogram should be performed when:
- The patient presents with symptoms and signs that are consistent with Buerger's disease but not definite.

Diagnostic Criteria

The diagnosis of Buerger's disease is based on the Shionoya's criteria, which includes:
- Less than 45 years old
- Past or current history of tobacco intake
- Ischemia of the distal extremities
- Arteriographic findings suggestive of thromboangiitis obliterans
- Exclusion of another organic causes such as a source of embolism, autoimmune disease, thrombophilia, or diabetes mellitus

References

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@@ Line 1: / Line 1: @@
 __NOTOC__
 {{Buerger's disease}}
+{{CMG}}; {{AE}}{{HM}}
-{{CMG}}; {{AE}}{{HM}}
+==Overview==
-== Overview ==
+Although clinical examination is sufficient for diagnosis, in cases where diagnosis is not definitive, a catheter-based arteriogram is the gold standard test for the diagnosis of Buerger disease. The following result of catheter-based arteriogram is confirmatory of Buerger disease and includes, absence of atherosclerosis, no cause for thromboembolism, small and medium-sized vessels involved, namely tibial, popliteal, and radial arteries, segmental affection of vessels between normal appearing segments and corkscrew collaterals described as collateralization around occlusion area but are not pathognomonic.
 ==Diagnostic Study of Choice==
@@ Line 15: / Line 16: @@
 **Corkscrew collaterals described as collateralization around occlusion area but are not pathognomonic
+=====Sequence of Diagnostic Studies=====
+*The catheter-based arteriogram should be performed when:
+**The patient presents with symptoms and signs that are consistent with Buerger's disease but not definite.
-===== Sequence of Diagnostic Studies =====
+===Diagnostic Criteria===
-The catheter-based arteriogram should be performed when:
+*The diagnosis of Buerger's disease is based on the Shionoya's criteria, which includes:
-*The patient presents with symptoms and signs that are consistent with Buerger's disease but not definite.
+**Less than 45 years old
+**Past or current history of tobacco intake
-=== Diagnostic Criteria ===
+**Ischemia of the distal extremities
-* Here you should describe the details of the diagnostic criteria.
+**Arteriographic findings suggestive of thromboangiitis obliterans
-*Always mention the name of the criteria/definition you are about to list (e.g. modified Duke criteria for the diagnosis of endocarditis / 3rd universal definition of MI) and cite the primary source of where this criteria/definition is found.
+**Exclusion of another organic causes such as a source of embolism, autoimmune disease, thrombophilia, or diabetes mellitus
-*Although not necessary, it is recommended that you include the criteria in a table. Make sure you always cite the source of the content and whether the table has been adapted from another source.
-*Be very clear as to the number of criteria (or threshold) that needs to be met out of the total number of criteria.
-*Distinguish criteria based on their nature (e.g. clinical criteria / pathological criteria/ imaging criteria) before discussing them in details.
-*To view an example (endocarditis diagnostic criteria), click [[Endocarditis diagnosis|here]]
-*If relevant, add additional information that might help the reader distinguish various criteria or the evolution of criteria (e.g. original criteria vs. modified criteria).
-*You may also add information about the sensitivity and specificity of the criteria, the pre-test probability, and other figures that may help the reader understand how valuable the criteria are clinically.
-* [Disease name] is mainly diagnosed based on clinical presentation. There are no established criteria for the diagnosis of [disease name].
-* There is no single diagnostic study of choice for [disease name], though [disease name] may be diagnosed based on [name of criteria] established by [...].
-* The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met: [criterion 1], [criterion 2], [criterion 3], and [criterion 4].
-* The diagnosis of [disease name] is based on the [criteria name] criteria, which includes [criterion 1], [criterion 2], and [criterion 3].
-* [Disease name] may be diagnosed at any time if one or more of the following criteria are met:
-** Criteria 1
-** Criteria 2
-** Criteria 3
-IF there are clear, established diagnostic criteria:
-*The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met: [criterion 1], [criterion 2], [criterion 3], and [criterion 4].
-*The diagnosis of [disease name] is based on the [criteria name] criteria, which include [criterion 1], [criterion 2], and [criterion 3].
-*The diagnosis of [disease name] is based on the [definition name] definition, which includes [criterion 1], [criterion 2], and [criterion 3].
-IF there are no established diagnostic criteria:
-*There are no established criteria for the diagnosis of [disease name].
 ==References==