Differential Diagnosis
- Single most likely diagnosis
- Peripheral Arterial Disease (PAD): The patient's symptoms, including decreased pulses in the lower extremities (femoral 2/4, popliteal 2/4, dorsalis pedis 1/4, and posterior tibial 1/4), warm to cold skin temperature gradient from proximal to distal, and sparse hair growth, are consistent with PAD. The presence of moderate non-pitting edema, erythema, and digital capillary return of less than three seconds also support this diagnosis.
- Other Likely diagnoses
- Atherosclerosis: The patient's symptoms, such as decreased pulses and sparse hair growth, could be related to atherosclerosis, which is a common cause of PAD.
- Hypertension: Uncontrolled hypertension can lead to vascular damage, which may contribute to the patient's symptoms.
- Diabetes mellitus: Diabetes is a risk factor for PAD and can cause similar symptoms, including decreased pulses and skin changes.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Acute limb ischemia: Although the patient's symptoms are chronic, it is essential to rule out acute limb ischemia, which is a medical emergency that requires prompt treatment.
- Embolic event: An embolic event, such as a pulmonary embolism or a cardiac embolism, could cause similar symptoms and requires immediate attention.
- Vasculitis: Vasculitis, such as giant cell arteritis or Takayasu arteritis, can cause vascular inflammation and damage, leading to similar symptoms.
- Rare diagnoses
- Buerger's disease (Thromboangiitis obliterans): This rare disease causes inflammation and clotting of blood vessels, leading to decreased pulses and skin changes.
- Raynaud's phenomenon: This condition causes vasospasm of blood vessels, leading to decreased pulses and skin changes, particularly in response to cold temperatures or stress.
- Popliteal artery entrapment syndrome: This rare condition causes compression of the popliteal artery, leading to decreased pulses and skin changes in the affected limb.