Buerger's Disease

Definition:

It is a progressive,peripheral,vascular occlusive disease due to involvement of all the three layers of small to medium sized arteries in an non specific inflammatory process.

Features:

1.Occlusive disease of medium and small sized arteries:

• Digital
• Planter
• Dorsalis pedis
• Anterior tibial
• Radial

2.Thrombophlebitis of superficial and deep veins.
3.Raynaud's phenomenon:In male patient in younger age group.

Symptoms:

1.Pain in the limb
a)Intermittent claudication
b)Rest pain
Tingling and numbness/Paresthesia

• Loss of sensation
• Coldness of the part
• Color changes
• Ulceration or combination of the affected part

 Buerger's Disease pictures:

Sign:

A.General signs:

1.patient is anxious
2.Patient prefers to sit by the side of the bed hanging the limb,unwilling to lie flat

B.Local signs:

• Inspection:

1. Color changes with line of demarcation
2. Loss of hair
3. Skin-dry,shrivelled,mummified,blackened,greasy to touch
4. Ulcer (if any) examine accordingly
5. Nails:falling or trophic changes.
6. Muscle wasting.

• Palpation:

1. Temp:cold
2. Pulse:lost
3. Sensation:decreased
4. Motor power:decreased
5. Reflex function:decreased
6. Buerger's test
7. Buerger's angle.

• Auscultation:

1. Bruit

C.Systemic examination: CVS

Treatment:

A.General:

1. Stop smoking:prevents progress of disease
2. Nutritious diet and vitamin supplements
3. Care of the foot/feet:wearing soft shoes and socks,keeping the feet dry,Careful paring of toe nails
4. Regular exercise within the limit of claudication pain(distance)
5. Vasodilator drugs:Nicotinic acid,Isosorbide dinitrate
6. Analgesics:Diclofenac

B.Specific Rx:Depends on the condition/situation