Progressive Right Forefoot Pain in Surgery — 68yo Man | Vascular Surgery | SMLE Q#20274

SMLE Question #20274

Surgery Vascular Surgery

Objective: OBJ-AAA-SURV-001

Last updated: July 2026
A 68-year-old man with long-standing diabetes mellitus and a 50 pack-year smoking history presents with progressive right forefoot pain and a nonhealing ulcer on the right great toe for 6 weeks. Examination shows a cool, shiny right foot with absent dorsalis pedis and posterior tibial pulses and capillary refill of 5 seconds. Ankle-brachial index on the right is 0.25. What is the clinical hallmark of critical limb ischemia?

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