A 60yo smoker presents with cramp-like pain in the calves relived by rest and non-healing ulcers.
Exam: cold extremities with lack of hair around the ankles, absent distal pulses. What is the
most probable dx?
a. Intermittent claudication
b. Chronic ischemia of the limbs
c. Buerger’s disease
Q. 1. What is the key?
Q. 2. Points that support your diagnosis.
Ans. 1. The key is B. Chronic ischaemia of the limb.
Ans. 2. Intermittent claudication is a symptom not diagnosis. It is not buerger’s disease as buerger occur in more younger heavy smoker (before the age of 50yrs), It is not DVT as dvt pain or tenderness is not of an intermittent claudication pattern. Again in DM there is no intermittent claudication.