Clinical examination for PAI:
Inspection
- Colour
- Skin changes – shiny, scaly, dry (“atrophic”), loss hair, thickened nails, atrophy subcutaneous tissue, muscle mass
- ulcer / gangrene (necrosis)
Palpation
- cold (cf. other side)
- ulcer – painful
- pulses – reduced or absent
- capillary refill time (CRT) (normal is < 2 seconds)
- Buerger’s postural test (elevate limbs and see pallor)
- abdominal aortic aneurysm (AAA)
Auscultation
- bruits – femoral, abdominal, renal, carotid, vertebral (± exercise)
- full CVS system examination
- anaemia, coronary artery disease (CAD)
- retinal examination
- blood pressure
- think: coronary, cerebral, renal perfusion
- full Respiratory system examination, incl. ask about smoking
- FBC – Hb (anaemia/polycythaemia), WCC, thrombocytosis
- Blood sugar level (BSL) – diabetes mellitus
- Serum lipids
- ECG – silent infarct → stress test, coronary angiography
- CXR – smokers
- Urinalysis (diabetes mellitus)
Reference
Li, Xiaoyun; Wang, Ling; Zhang, Chi; Li, Shuyu; Pu, Fang, Yubo; and Li, Deyu. “Why Is ABI Effective in Detecting Vascular Stenosis?
Investigation Based on Multibranch Hemodynamic Model.” The Scientific World Journal 2013: 1-10.
