Thrombo-Angiitis Obliterans (Buerger'S Disease) in the West of Scotland

The available case records relating to all admissions to hospitals in the Western Region of Scotland in which a diagnosis of thrombo-angiitis obliterans had been made in the years 1961–68 inclusive were reviewed. These records referred to 93 patients, 90 of whom were domiciled in the West of Scotland. In 40 cases it was immediately apparent that the diagnosis was incorrect. In the remaining 50 cases the diagnosis was re-assessed using a diagnostic index based on certain well-defined clinical features. When this had been done it was considered that the diagnosis of thrombo-angiitis obliterans was probably correct in 13 cases and possibly correct in a further 14. In those cases in which material obtained by biopsy or at amputation had been examined by a pathologist there was not a good correlation between the final clinical diagnosis and the opinion expressed by the pathologist. It is concluded that thrombo-angiitis obliterans is an extremely rare disease and that although the diagnosis is made much less often than it used to be it is still made too readily. The similarity between the clinical features of thrombo-angiitis obliterans and the manifestations of peripheral arterial disease in diabetes mellitus is stressed.