Summary
Definition
History and exam
Other diagnostic factors
- paresthesias/cold sensation/cyanosis in limb or finger
- ulceration/gangrene
- claudication
- rest pain
- superficial thrombophlebitis
- cold limb or finger
- pale limb or finger
- absence of distal pulses
- positive Allen test
- joint arthritis
- duration of joint symptoms up to 2 weeks
Risk factors
- smoking
- age <40 years
- region of origin: southeast Mediterranean, Middle East, and Far East
- male sex
- periodontal infection
- human leukocyte antigen (HLA) haplotypes
Diagnostic investigations
1st investigations to order
- blood glucose
- BUN
- serum creatinine
- CBC with differential
- coagulation screen
- thrombophilia screen
- CRP
- ESR
- arterial Doppler
Investigations to consider
- antinuclear antibody
- rheumatoid factor
- antineutrophilic cytoplasmic antibody (ANCA)
- complement levels
- anticentromere antibody
- topoisomerase I antibodies (Scl-70)
- echocardiogram
- arterial duplex
- digital subtraction angiography
- anticardiolipin antibodies
Emerging tests
- CT angiography
- magnetic resonance angiography
- tissue biopsy
- genetic testing
Treatment algorithm
Contributors
Authors VIEW ALL
Consultant Vascular Surgeon
Lister Hospital
East and North Hertfordshire NHS Trust
Hertfordshire
UK
Disclosures
MJM declares that he has no competing interests.
Professor of Vascular Surgery and Honorary Consultant Surgeon
Department of Vascular Surgery
Faculty of Medicine
Imperial College of Medicine
Charing Cross Hospital
London
UK
Disclosures
AHD declares that he has no competing interests.
Peer reviewers VIEW ALL
Department of Vascular Surgery
Red Cross Hospital
Athens
Greece
Disclosures
KIP declares that he has no competing interests.
Assistant Professor of Surgery
Division of Vascular Surgery
University of Texas Health Science Center at San Antonio
San Antonio
TX
Disclosures
MKS declares that she has no competing interests.
Chief of Vascular Surgery
Director
Gonda Vascular Center
David Geffen School of Medicine at UCLA
Los Angeles
CA
Disclosures
PFL declares that he has no competing interests.
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