Differential Diagnosis for Elevated Velocities in the Right Common Femoral Artery
Single Most Likely Diagnosis
- Atherosclerotic disease: This is the most common cause of arterial stenosis, especially in older adults, and can lead to elevated velocities in the affected artery due to narrowing of the arterial lumen.
Other Likely Diagnoses
- Fibromuscular dysplasia: A non-atherosclerotic, non-inflammatory vascular disease that affects medium- and large-sized arteries, most commonly the renal and internal carotid arteries, but can also affect the femoral arteries.
- Arterial thrombosis or embolism: Although less likely given the description of "mildly elevated velocities" and "widely patent" vasculature, it's a consideration, especially if there's a source of embolism or a hypercoagulable state.
- Vasculitis: Inflammatory diseases of the blood vessels, such as giant cell arteritis or Takayasu arteritis, can cause stenosis and elevated velocities, though they are less common.
Do Not Miss Diagnoses
- Aortic dissection or aortoiliac occlusive disease: Although the question mentions the right lower extremity arterial vasculature is widely patent, missing an aortic dissection or significant aortoiliac disease could be catastrophic. These conditions can lead to severe limb ischemia, organ infarction, or even death.
- Popliteal artery entrapment syndrome: This is a rare condition but can cause claudication and ischemic symptoms in the lower extremity due to compression of the popliteal artery.
Rare Diagnoses
- Arterial tortuosity syndrome: A rare genetic disorder characterized by tortuosity and stenosis of the arteries, which could potentially cause elevated velocities.
- Williams syndrome: A genetic disorder that can cause arterial stenosis, including supravalvular aortic stenosis, and potentially affect other arteries, including the femoral arteries.
- Neurofibromatosis: Can cause vascular abnormalities, including stenosis or occlusion of arteries, due to the presence of neurofibromas or other vascular lesions.