Peripheral Artery Disease: Or something else? Differential Diagnosis

Cardiovascular System (I00-I99).

  • Acute arterial occlusion (acute arterial vascular occlusion).
  • Acrocyanosis – bluish-red discoloration of the hands, feet, and other ends of the body that may be permanent or temporary, resulting from various cardiopulmonary diseases
  • Erythromelalgia (EM; erythro = red, melos = limb, algos = pain) – acral circulatory disorder characterized by seizure-like redness and overheating of the skin on the extremities (hands/feet) associated with burning pain; vasodilation (dilation of blood vessels) provokes the overheating of the skin and painful redness here; disease is very rare
  • Fibromuscular dysplasia – structural changes in the wall of the arteries, which lead to narrowing of the diameter of the vessels.
  • Popliteal aneurysm – outpouching of the knee artery with the risk of thromboembolism (sudden vessel occlusion due to a thrombus that has detached from the vessel wall)
  • Popliteal compression syndrome – compression of the knee artery due to anatomical variations.
  • Raynaud’s syndrome – seizure-like vasospasm of the finger and toe arteries.
  • Thrombangiitis obliterans (synonyms: endarteritis obliterans, Winiwarter-Buerger disease, Von Winiwarter-Buerger disease, thrombangitis obliterans) – vasculitis (vascular disease) associated with recurrent (recurring) arterial and venous thrombosis (blood clot (thrombus) in a blood vessel); symptoms: Exercise-induced pain, acrocyanosis (blue discoloration of body appendages), and trophic disturbances (necrosis/tissue damage resulting from cell death and gangrene of fingers and toes in advanced stages); more or less symmetrical occurrence; young patients (< 45 years).
  • Venous claudication – massive venous outflow obstruction of the thigh and pelvic axis (causes: chronic venous insufficiency (CVI), in condition after multilevel thrombosis; symptoms: Bursting pain with walking load, improvement of pain only with elevation).
  • Cystic adventitia degeneration – formation of fluid-filled cavities (cysts) in the arteries, which lead to vasoconstriction.

Musculoskeletal system and connective tissue (M00-M99).

  • Compartment syndrome, chronic (condition in which, with the skin and soft tissue sheath closed, increased tissue pressure leads to a decrease in tissue perfusion, resulting in neuromuscular dysfunction or tissue and organ damage).
  • Livedo – striped livid discoloration of the skin, which occurs perceptibly in vasculitides (vascular inflammation).

Psyche – nervous system (F00-F99; G00-G99)

  • Compression of the spinal cord in the cervical spinal canal (myelopathy) – leading symptom is a slowly increasing spastic gait disorder, this is combined with sensory disturbances in the legs (spinal claudication; causes: Degenerative spinal changes, disc prolapse (herniated disc), spinal stenosis (spinal canal stenosis); symptoms: Leg pain when walking downhill or after prolonged standing, radicular symptoms).
  • Neuropathy (causes: Avitaminoses (B12, folic acid), alcohol abuse, diabetes mellitus, and drug and toxic causes; symptoms: nocturnal leg pain, improvement with exposure to cold, nocturnal calf cramps, improvement with walking).
  • Peripheral nerve pain (nerve root compression).
  • Piriformis syndrome – compression of the sciatic nerve (ischiadicus) as it passes through the infrapiriform foramen between the pelvic bone and the piriformis muscle (DD discopathy/disc damage).