Q:

A 60 year old smoker presents with cramp-like pain in the calves relived by rest and non-healing ulcers. Examination: cold extremities with lack of hair around the ankles, absent distal pulses. What is the most probable diagnosis?

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A 60 year old smoker presents with cramp-like pain in the calves relived by rest and non-healing ulcers. Examination: cold extremities with lack of hair around the ankles, absent distal pulses. What is the most probable diagnosis?


  1. Intermittent claudication
  2. Chronic ischemia of the limbs
  3. Buerger’s disease
  4. DVT
  5. DM

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The key is B. Chronic ischaemia of the limb. [Intermittent claudication is a symptom not diagnosis. It is not buerger’s disease as buerger occur in more younger heavy smoker (before the age of 50yrs), It is not DVT as dvt pain or tenderness is not of an intermittent claudication pattern. Again in DM there is no intermittent claudication].

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