Case of 30 year chronic smoker male, visited your clinic with this condition. Diagnosis:

Ans. (b) Buerger's disease.Buerger's disease is also known as thromboangiitis obliterans. An inflammatory and obliterative disease of blood vessels of the extremities, mainly lower extremities. Occurring chiefly in smoker young men and leading to ischemia of the tissues and gangrene. Involvement of artery vein and nerve, most commonly involved is tibial artery. Intermittent claudication, pain at rest relieved by dangling legs. Dry gangrene in toes shows shriveled woody induration.IOC: Duplex USG (ankle brachial index: 0.5 to 0.9)Treatment: For Claudication pain, reducing the viscosity of blood pentoxifylline is used. For resting pain, lumbar sympathectomy. If gangrene, amputation done.Image source- style="font-family: Times New Roman, Times, serif">