Buerger’s disease is characterized by all of the following except:
A. Arterial thrombosis formation and occlusion.
B. Lipid deposits in the arteries.
C. Redness or cyanosis in the limb when it is dependent.
D. Venous inflammation and occlusion.
Correct Answer: B. Lipid deposits in the arteries
Buerger disease, also known as Thromboangiitis obliterans (TAO) is a progressive, nonatherosclerotic, segmental, inflammatory disease that most often affects small and medium arteries of the upper and lower extremities. The typical age range for occurrence is 20 to 50 years, and the disorder is more frequently found in males who smoke.
Option A: Patients initially present with foot, leg, arm, or hand claudication which may be mistaken for joint or neuromuscular problems. Progression of the disease leads to calf claudication, and eventually, ischemic rest pain and ulcerations on the toes, feet, or fingers. This is also called Raynaud’s.
Option C: Patients with TAO typically present with ischemic signs and symptoms in the distribution of the distal arteries of the upper or lower extremities. Manifestations may include claudication in the arch of the foot as well as the calf. This is also called Raynaud’s phenomenon or livedo reticularis that presents as pain in hands, feet, and digits at rest.
Option D: TAO commonly begins in the distal extremities, but as the disease progresses, it will affect the proximal vessels. The Allen test is done to test the extent of the initial disease. Superficial thrombophlebitis complicates almost half of all cases of TAO. Due to associated neurologic involvement, paresthesias of the acral portions of the upper and lower extremities are often described.
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