45 y male Chronic smoker / DM since 3 years on irregular treatment . C/o severe pain in left leg since 28th April , progressive in nature . No other medical history Spot diagnosis Advice further line of management !!



Venous thrombosis

Burgers disease aggrevated by DM

Peripheral vascular disease

Burger's disease with diabetes ulcer..

Necrotic lesions with ulcerations in mid and lower part of leg suggest TAO, which is the classical picture of Buerger disease which may be aggreviated by Diabetes.Needs further investigations for vascular status,if diabetic it's status,and case may be under care of Surgeon

Seems like limb necrosis due to peripheral vascular disease maybe Burger's disease

Burger's disease

Venous ulcer

Buerger's disease aggravated by Diabetic neuropathy and microangiopathy . Get a colour Doppler study of lower limb vessels to ascertain the level of block. A proper examination of lower limb peripheral vessels will ascertain along with Doppler study as to whether amputation is required or not. Achieve strict glycaemic control with insulin. Stop immediate cessation of smoking.

Diabetic ulcer with microangiopathy

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