Buerger's test is used in an assessment of arterial sufficiency. It is named after
Leo Buerger Leo Buerger (English ; ) (September 13, 1879 in Vienna – October 6, 1943 in New York City) was an Austrian American pathologist, surgeon and urologist. Buerger's disease is named for him.
Family and education
In 1880s his family emigrated t ...
. The ''vascular angle'', which is also called ''Buerger's angle'', is the angle to which the leg has to be raised before it becomes pale, whilst
lying down. In a limb with a normal
circulation the toes and sole of the foot, stay pink, even when the limb is raised by 90 degrees. In an
ischaemic
Ischemia or ischaemia is a restriction in blood supply to any tissue, muscle group, or organ of the body, causing a shortage of oxygen that is needed for cellular metabolism (to keep tissue alive). Ischemia is generally caused by problems wi ...
leg, elevation to 15 degrees or 30 degrees for 30 to 60 seconds may cause
pallor
Pallor is a pale color of the skin that can be caused by illness, emotional shock or stress, stimulant use, or anemia, and is the result of a reduced amount of oxyhaemoglobin and may also be visible as pallor of the conjunctivae of the eyes o ...
. (This part of the test checks for ''elevation pallor''.) A vascular angle of less than 20 degrees indicates severe ischaemia.
[ ]
From a sitting position, in normal circulation, the foot will quickly return to a pink colour. Where there is
peripheral artery disease
Peripheral artery disease (PAD) is an abnormal narrowing of arteries other than those that supply the heart or brain. When narrowing occurs in the heart, it is called coronary artery disease, and in the brain, it is called cerebrovascular diseas ...
the leg will revert to the pink colour more slowly than normal and also pass through the normal pinkness to a red-range colouring (''rubor'' - redness) often known as ''sunset foot''. This is due to the dilatation of the
arteriole
An arteriole is a small-diameter blood vessel in the microcirculation that extends and branches out from an artery and leads to capillaries.
Arterioles have muscular walls (usually only one to two layers of smooth muscle cells) and are the primar ...
s in an attempt to rid the metabolic waste that has built up in a reactive
hyperaemia
Hyperaemia (also hyperemia) is the increase of blood flow to different tissues in the body. It can have medical implications but is also a regulatory response, allowing change in blood supply to different tissues through vasodilation. Clinically, ...
. Finally the foot will return to its normal colour. This part of the test is known as a check for ''rubor of dependency''.
The test may also be used in the diagnosis of
erythromelalgia
Erythromelalgia or Mitchell's disease (after Silas Weir Mitchell) is a rare vascular peripheral pain disorder in which blood vessels, usually in the lower extremities or hands, are episodically blocked (frequently on and off daily), then become ...
.
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See also
*
Peripheral vascular examination
*
Claudication
Claudication is a medical term usually referring to impairment in walking, or pain, discomfort, numbness, or tiredness in the legs that occurs during walking or standing and is relieved by rest. The perceived level of pain from claudication can be ...
References
Vascular procedures
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