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.
Ultrasound of Incompetent SaphenoFemoral Junction Valve
59 year old male with short distance exercise induced left leg pain. Pain was severe and was interfering with the patients actively living.
Current physiologic testing for ulcer perfusion may fail to identify patients with ischemia