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{{Buerger's disease}}
{{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 artery|tibial]], [[Popliteal artery|popliteal]], and [[Radial artery|radial]] arteries, segmental affection of vessels between normal appearing segments and corkscrew collaterals described as collateralizations around an occlusion area but are not [[pathognomonic]].


==Diagnostic Study of Choice==
==Diagnostic Study of Choice==
===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.
*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.<ref name="pmid5431503">{{cite journal |vauthors=Lambeth JT, Yong NK |title=Arteriographic findings in thromboangiitis obliterans with emphasis on femoropopliteal involvement |journal=Am J Roentgenol Radium Ther Nucl Med |volume=109 |issue=3 |pages=553–62 |date=July 1970 |pmid=5431503 |doi= |url=}}</ref><ref name="pmid22784658">{{cite journal |vauthors=Dimmick SJ, Goh AC, Cauzza E, Steinbach LS, Baumgartner I, Stauffer E, Voegelin E, Anderson SE |title=Imaging appearances of Buerger's disease complications in the upper and lower limbs |journal=Clin Radiol |volume=67 |issue=12 |pages=1207–11 |date=December 2012 |pmid=22784658 |doi=10.1016/j.crad.2012.04.005 |url=}}</ref><ref name="pmid5431503">{{cite journal |vauthors=Lambeth JT, Yong NK |title=Arteriographic findings in thromboangiitis obliterans with emphasis on femoropopliteal involvement |journal=Am J Roentgenol Radium Ther Nucl Med |volume=109 |issue=3 |pages=553–62 |date=July 1970 |pmid=5431503 |doi= |url=}}</ref><ref name="pmid19536378">{{cite journal |vauthors=Yoshimuta T, Akutsu K, Okajima T, Tamori Y, Kubota Y, Takeshita S |title=Corkscrew collaterals in Buerger's disease |journal=Can J Cardiol |volume=25 |issue=6 |pages=365 |date=June 2009 |pmid=19536378 |pmc=2722480 |doi= |url=}}</ref>
*The following result of catheter-based arteriogram is confirmatory of Buerger disease:
*The following result of catheter-based arteriogram is confirmatory of Buerger disease:
**Absence of atherosclerosis
**Absence of [[atherosclerosis]]
**No cause for thromboembolism  
**No cause for [[thromboembolism]]
**Small and medium-sized vessels involved, namely tibial, popliteal, and radial arteries
**Small and medium-sized vessels involved, namely [[Tibial artery|tibial]], [[Popliteal artery|popliteal]], and [[Radial artery|radial]] arteries
**Segmental affection of vessels between normal appearing segments
**Segmental affection of vessels between normal appearing segments
**Corkscrew collaterals described as collateralization around occlusion area but are not pathognomonic  
**Corkscrew collaterals described as collateralization around occlusion area but are not pathognomonic  


=====Sequence of Diagnostic Studies=====
*The catheter-based arteriogram should be performed when:<ref name="pmid20421527">{{cite journal |vauthors=Piazza G, Creager MA |title=Thromboangiitis obliterans |journal=Circulation |volume=121 |issue=16 |pages=1858–61 |date=April 2010 |pmid=20421527 |pmc=2880529 |doi=10.1161/CIRCULATIONAHA.110.942383 |url=}}</ref>
**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:<ref name="pmid9951826">{{cite journal |vauthors=Shionoya S |title=Diagnostic criteria of Buerger's disease |journal=Int. J. Cardiol. |volume=66 Suppl 1 |issue= |pages=S243–5; discussion S247 |date=October 1998 |pmid=9951826 |doi= |url=}}</ref><ref name="pmid6624130">{{cite journal |vauthors=Shionoya S |title=What is Buerger's disease? |journal=World J Surg |volume=7 |issue=4 |pages=544–51 |date=July 1983 |pmid=6624130 |doi= |url=}}</ref><ref name="pmid16698911">{{cite journal |vauthors=Lazarides MK, Georgiadis GS, Papas TT, Nikolopoulos ES |title=Diagnostic criteria and treatment of Buerger's disease: a review |journal=Int J Low Extrem Wounds |volume=5 |issue=2 |pages=89–95 |date=June 2006 |pmid=16698911 |doi=10.1177/1534734606288817 |url=}}</ref>
*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 cause such as a source of [[embolism]], [[Autoimmune disease|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==
==References==

Latest revision as of 17:39, 11 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]

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 collateralizations around an 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.[1][2][1][3]
  • 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:[4]
    • 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:[5][6][7]
    • 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 cause such as a source of embolism, autoimmune disease, thrombophilia, or diabetes mellitus.

References

  1. ↑ 1.0 1.1 Lambeth JT, Yong NK (July 1970). "Arteriographic findings in thromboangiitis obliterans with emphasis on femoropopliteal involvement". Am J Roentgenol Radium Ther Nucl Med. 109 (3): 553–62. PMID 5431503.
  2. ↑ Dimmick SJ, Goh AC, Cauzza E, Steinbach LS, Baumgartner I, Stauffer E, Voegelin E, Anderson SE (December 2012). "Imaging appearances of Buerger's disease complications in the upper and lower limbs". Clin Radiol. 67 (12): 1207–11. doi:10.1016/j.crad.2012.04.005. PMID 22784658.
  3. ↑ Yoshimuta T, Akutsu K, Okajima T, Tamori Y, Kubota Y, Takeshita S (June 2009). "Corkscrew collaterals in Buerger's disease". Can J Cardiol. 25 (6): 365. PMC 2722480. PMID 19536378.
  4. ↑ Piazza G, Creager MA (April 2010). "Thromboangiitis obliterans". Circulation. 121 (16): 1858–61. doi:10.1161/CIRCULATIONAHA.110.942383. PMC 2880529. PMID 20421527.
  5. ↑ Shionoya S (October 1998). "Diagnostic criteria of Buerger's disease". Int. J. Cardiol. 66 Suppl 1: S243–5, discussion S247. PMID 9951826.
  6. ↑ Shionoya S (July 1983). "What is Buerger's disease?". World J Surg. 7 (4): 544–51. PMID 6624130.
  7. ↑ Lazarides MK, Georgiadis GS, Papas TT, Nikolopoulos ES (June 2006). "Diagnostic criteria and treatment of Buerger's disease: a review". Int J Low Extrem Wounds. 5 (2): 89–95. doi:10.1177/1534734606288817. PMID 16698911.

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