94 year old female, worsening right toe and foot pain. Seen by primary care and diagnosed as having gout. The clinical findings of critical limb ischemia - dry scaly skin, nail changes, absent pulses and a punched out ulcer on the 2nd toe - were ignored. Popliteal artery occlusion treated with atherectomy.
Short distance claudication and rest pain secondary to thrombosed popliteal artery aneurysm treated endovasculary.
46 year old male, type 1 diabetes, with ulcers on several toes. Patient had palpable pulses at the ankle.
Current physiologic testing for ulcer perfusion may fail to identify patients with ischemia