Differential Diagnosis
Diagnosis
Clinical Criteria
- Criteria are not universally accepted but include
- Age less than 50 years (or 45 years)
- Current or recent tobacco use
- Ischemia of the distal extremities, documented by vascular testing
- Typical arteriographic findings, including corkscrew appearance, spider legs, or tree roots
- Exclusion of other causes, including autoimmune diseases, thrombophilia, diabetes mellitus, and thromboembolism
Investigations
- CBC, liver panel, electrolytes, cretinine, HbA1c, lipid panel, urinalysis
- ESR/CRP
- ANA, RF, cryoglobulins, complements, anti-centromere (for CREST), anti-Scl-70 (for scleroderma), antiphospholipid antibodies
- Protein C & S, antithrombin III, Factor V Leiden, prothrombin, homocysteinemia
- Toxicology for cocaine and amphetamines
- Ultrasound with segmental arterial Dopplers
- Echocardiography (for embolic source)
- +/- CT (for embolic source)
- Biopsy, maybe
