How is Thromboangiitis Obliterans diagnosed?
To confirm your clinical diagnosis, you need to exclude conditions that mimic TO. The most important and common of these are atherosclerosis, emboli, autoimmune diseases, hypercoagulable state, and diabetes.
There are no specific tests to aid in the diagnosis. Complete blood count, liver function tests, urinalysis, fasting blood glucose, acute-phase reactants (ESR/CRP), and serologic tests (ANA, RF) are usually normal or negative. All patients suspected of having TO should undergo an echocardiogram to rule out cardiac thrombi, vascular studies such as ankle-brachial index and duplex ultrasound, and an arteriogram. The arteriogram will also help confirm your clinical diagnosis of TO and rule out atherosclerosis. Arteriographic findings are suggestive (though not pathognomonic) of the disease. Although CTA and MRA can be used, these modalities may not provide sufficient spatial resolution to provide adequate details of the hand and feet vasculature.
