Spotter of the week

18 NOV 2014

What Renuka Says Spotter Series ...

Dr Anshad Ameen N, MEM Y-I

69 Year old male with k/c/o DM-for 30 years and right sided hemiplegia -8 years back right sided BK amputatioin 7 years back
Now coming with c/o Decreased movement of left side of body-for 1wk & left leg discolouration & pain for 3 days..

On examination
Pulse absent in left popletial & dorsalis pedis..
Lab values-increased tc(27000)

DIAGNOSIS..??
A/C LIMB ISCHEMIA

ACUTE LIMB ISCHEMIA
PERIPHERAL ARTERIAL D/S ----ABI<.9
C/F—6Ps
Pain
Pallor
Poikilothermia
Pulselessness
Parasthesia
paralysis
Pain-earliest symptom
One of the early sign the of ischemic limb may present as muscle weakness.

DDs-
Thromboembolic d/s
Vasculitis
Raynaud d/s
TAO

DIAGNOSIS
ARTERIOGRAM-GOLD STD