title: The acute blue finger: management and outcome.
abstract: BACKGROUND
  The objective was to assess the management, and short- and longer-term outcome of patients presenting with an acute blue finger.
  
  
  METHODS
  This was a retrospective, case-note review and prospective follow-up by telephone and general practitioner enquiry. All patients who presented with sudden onset blue discolouration of a finger within the previous 72 h, with normal radial and ulnar pulses, were included.
  
  
  RESULTS
  From 2000 to 2006, 22 patients, 15 female, 7 male, were reviewed. Median age was 56 years (range, 19-88 years). Median time from onset of blue finger was 6 days (range 1 day to 3 months). In most cases (17), no underlying cause was identified. Five patients had an underlying cause; two had symptoms compatible with Raynaud's phenomenon, one patient had signs (later confirmed on MRA) of arterial thoracic outlet syndrome and two had polycythaemia (haemoglobin > 17 g/dl). Otherwise, all laboratory investigations were normal. Upper limb duplex, echocardiogram and 24-h cardiac tapes were normal in all cases. Median follow-up was 19 months. Three patients had recurrent symptoms in the finger. No patient suffered tissue loss or loss of digit(s), and none had stroke or arterial embolisation.
  
  
  CONCLUSIONS
  The acute blue finger is a benign condition not suggestive of arterial embolisation. Tissue or digit loss is not a threat and, in the longer term, there is no threat of embolisation to other vascular sites.
authors.affiliation: Department of Vascular Surgery, The John Radcliffe, Oxford, UK.
authors.forename: R
authors.initials: R
authors.lastname: Cowen
authors.forename: T
authors.initials: T
authors.lastname: Richards
authors.forename: A
authors.initials: A
authors.lastname: Dharmadasa
authors.forename: A
authors.initials: A
authors.lastname: Handa
authors.forename: J M T
authors.initials: JM
authors.lastname: Perkins
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005385:Fingers / Q000098:blood supply*; D005500:Follow-Up Studies; D006801:Humans; D007511:Ischemia / Q000209:etiology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D055815:Young Adult