Nontraumatic isolated acute thumb ischaemia

摘要

A 68-year-old man who was an ex-smoker presented with progressively'worsening bluish discoloration of the right thumb associated with coldness, numbness and dull pain of 8 hours duration. Past medical history included ischaemic heart disease, hypercholesterolaemia and impaired glucose tolerance. On examination, his thumb was cold and cyanosed from MCP joint level distally. Capillary refill was prolonged at 3 seconds. Radial, ulnar, brachial and axillary pulses were palpable. Systemic examination was unremarkable.