It may be. They do an ulltrasound as the first test which has less resolution than the angiogram images they take in the catherization lab.
When the vascular specialist first saw me after the ultrasound imaging he said, “You got plaque clogging your arteries. We need to do an angiogram on you and then a possible intervention in the cath lab. You’ll also need to take a low dose statin and a baby aspirin.”
When I objected and said, "Why would you give me a statin? My lipid studies are all on the low end of normal (i.e., “good”) and when I had that abdominal aortic aneurysm screening test a few years ago the ultrasound technician remarked, “You don’t even have any calcium deposits on your aorta. That’s very unusual for someone your age.”
Doctor said, “The distribution of plaque in the body varies from individual to individual. Just because you don’t have it in your abdominal aorta doesn’t mean it’s not elsewhere.”
It seems the angiogram is what’s required for the correct diagnosis. When all the doctor had was the ultrasound image, he was still thinking “plaque” (despite the fact that I don’t have high blood pressure, diabetes, or a lipid problem – the most common causes of plaque in the blood vessels.
I saw my Rheumatologist 3 weeks ago. (Since everything has been in remission for 25 years, I only see him him once or twice a year.) When I told him of the suspected lipid problem causing my foot to blow up he said, "there’s a rare form of lupus (Antiphospholipid Syndrome) that causes the immune system
to attack the lipid cells and create blood clots, I’ll check you for that.
I stopped at the lab on the way home and had the blood drawn right away. I noticed that there was 5 tubes of blood on the computer screen when they were doing the blood draw and I said, “I think there may be a mistake, I’m pretty sure my doctor only ordered one test.” Tech says, "This is one test, but I’ve never seen it before. We’re sending 3 tubes of blood to Phoenix and 2 to North Carolina. It looks like there are only a few places where they can do the test.
Results took about a week, and I don’t have Antiphospholipid Syndrome.
Reading up on leg aneurysms this morning, I found that they are a rare complication for people with a connective tissue disease (of which lupus is one) I don’t know if that insight was available when the leg swelling problem first presented for me 25 years ago, or something that medical science has put together recently.
If you have a disease that can be diagnosed with a blood test or x-ray, you have a better chance of success than when doctors have to put 3 or 4 different pieces of information together to make the correct diagnosis. Still amazing that it took a Physician Assistant at a strip mall doc-in-the-box to do that.
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