Southwest Journal of Pulmonary, Critical Care and Sleep

Those who care for patients with pulmonary, critical care or sleep disorders rely heavily on chest radiology and pathology to determine diagnoses. The Southwest Journal of Pulmonary, Critical Care & Sleep publishes case-based articles with characteristic chest imaging and related pathology. The editor of this section will oversee and coordinate the publication of a core of the most important chest imaging topics. In doing so, they encourage the submission of unsolicited manuscripts. It cannot be overemphasized that both radiologic and pathologic images must be of excellent quality. As a rule, 600 DPI is sufficient for radiographic and pathologic images. Taking pictures of plain chest radiographs and CT scans with a digital camera is strongly discouraged. The figures should be cited in the text and numbered consecutively. The stain used for pathology specimens and magnification should be mentioned in the figure legend. Those who care for patients with pulmonary, critical care or sleep disorders rely heavily on chest radiology and pathology to determine diagnoses. The Southwest Journal of Pulmonary, Critical Care & Sleep publishes case-based articles with characteristic chest imaging and related pathology. The editor of this section will oversee and coordinate the publication of a core of the most important chest imaging topics. In doing so, they encourage the submission of unsolicited manuscripts. It cannot be overemphasized that both radiologic and pathologic images must be of excellent quality. As a rule, 600 DPI is sufficient for radiographic and pathologic images. Taking pictures of plain chest radiographs and CT scans with a digital camera is strongly discouraged. The figures should be cited in the text and numbered consecutively. The stain used for pathology specimens and magnification should be mentioned in the figure legend.

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Thursday

Nov182010

Painful Necrotic Fingers

Thursday, November 18, 2010 at 1:17PM

Reference as: Raschke RA. Painful necrotic fingers. Southwest J Pulm Crit Care 2010;1:8-9. (Click here for PDF version)

A 38-year-old woman, an active smoker, presents with complaints of finger pain and changes in skin color. A photograph of the patients fingers is shown above. This photo was taken in 1989, before the hospital instituted a no smoking policy. Prior to that time, patients were allowed to smoke in their hospital rooms.

Catheter angiography was performed and showed a corkscrew configuration of the small arteries of the hand and fingers. Evaluation for connective tissue diseases was negative.

What is your diagnosis?

Answer: Buerger's disease (thombangitis obliterans).

Discussion

First described by Leo Buerger in 1908, Buerger’s disease (thrombangitis obliterans) is characterized by an inflammatory thrombosis of small to medium-sized arteries and veins, predominantly affecting the distal extremities. The disorder is unusual in women, but is extremely strongly associated with use of tobacco products. The only proven therapy for Buerger's disease is smoking cessation.

Robert A. Raschke, M.D.