Acute blue finger: a diagnostic challenge.
Mohamed Farag1, Mohamed Elmasry, Thato Mabote
1Department of General Medicine, Diana Princess of Wales Hospital, Grimsby, North East Lincolnshire, UK.
BMJ Case Reports
|January 17, 2014
Summary
Acute blue finger, often dismissed as benign, is a critical emergency. This case highlights subclavian arteritis leading to digit ischemia, emphasizing the need for prompt diagnosis and intervention to prevent severe outcomes like autoamputation.
Area of Science:
- Vascular Surgery
- Rheumatology
- Cardiology
Background:
- Acute blue finger management is debated, with some considering it benign.
- Prompt diagnosis and intervention are crucial for limb salvage.
Observation:
- A 43-year-old woman presented with a blue digit and joint issues.
- Initial assessment suggested rheumatoid arthritis or infective endocarditis.
- Bilateral radial and ulnar pulses were normal on examination.
Findings:
- CT angiography revealed significant proximal left subclavian stenosis.
- Diagnosis: left subclavian arteritis causing digit ischemia due to embolic debris.
- Subclavian angioplasty was performed.
Implications:
- Delayed management led to digit necrosis and autoamputation.
- This case underscores the emergency nature of acute blue finger.
- Highlights the importance of considering vascular emergencies in digit ischemia.
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