Medical education
Snapshot
Volume 213 - Issue 10
A curious case of finger pain
Authors: Warren Clements and Heather K Moriarty
Med J Aust 2020; 213 (10): 452-452.e1. || doi: 10.5694/mja2.50829
Published online: 16 November 2020
Published online: 16 November 2020
A 65-year-old man from a rural town presented with severe left- hand pain on a background of previously diagnosed Buerger disease
A 65‐year‐old man from a rural town presented with severe left‐hand pain on a background of previously diagnosed Buerger disease. He described arm and hand claudication over 30 years and a smoking history of 80 pack‐years. On examination, multiple small digital ulcers were identified (Figure, A). Catheter arteriogram (Figure, B) showed occlusion of the distal ulnar artery (red arrow), radial artery (blue arrow) and interosseous artery (red arrowhead), with collateral “corkscrew” vessels (blue arrowhead).
Thromboangiitis obliterans, or Buerger disease, is a non‐atherosclerotic vasculopathy of unknown aetiology. It occurs most commonly in men, with the age of onset in the 40s; is strongly associated with smoking; and is often progressive.1 Amputation is commonly required to manage pain or secondary infection.
Competing interests
No relevant disclosures.
References
- Cacione DG, Baptista‐Silva JCC, Macedo CR. Pharmacological treatment for Buerger's disease. Cochrane Database Syst Rev 2016; (2): CD011033.