[Digital ischemia: a diagnostic challenge]

Digital ischemia is suspected in presence of a cold, pale or cyanotic and painful finger. It is a diagnostic and therapeutic emergency and needs urgent referral to a vascular specialist. Digital pressure measurement is needed to confirm the diagnosis. A thorough history taking and physical examination help to guide patients' management. Antithrombotic therapy - with an antiplatelet or anticoagulant drug depending on the most likely etiology - need to be introduced without delay, while awaiting the results of the individualized etiologic workup. Hospital admission is often necessary. A prompt diagnostic and therapeutic management allows satisfactory pain control and avoidance of irreversible digital lesions in the majority of cases.