[Digital ischemia in a gardener: is rose cutting a vascular risk factor?].
METHODS
A 48-year-old right handed gardener presented with a white discoloration and numbness of her left ring finger. She reported cutting her roses without protection gloves so repetitive scratchy lesions especially of her left hand occurred.


METHODS
On examination the pulse of the left radial artery was absent. Allen's test showed a dominant ulnar supply of the palmar arch. Duplex ultrasound demonstrated an occluded aneurysm of the distal portion of the left radial artery. Furthermore there were occlusions of the first and fourth digital artery on MR angiography probably due to distal emboli of the radial aneurysm.


METHODS
After exclusion of systemic disease or vasculitis, an repetitive trauma due to rose thorns was supposed to be the cause of the radial aneurysm. Anticoagulation therapy was initiated and infusion of prostaglanden E1 was performed over 7 days. The digital ischemia resolved within a few days. Therefore a surgical procedure was not recommended.


CONCLUSIONS
In the presence of a radial artery aneurysm an occupational and recreational trauma history should be sought after.
Klinik für Innere Medizin, Sanakrankenhaus Wildbad. frank.stammler@sana-wildbad.de
F
F
Stammler
C
C
Grau
H-H
HH
Eckstein
D000527:Alprostadil / Q000627:therapeutic use; D000783:Aneurysm / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D000925:Anticoagulants / Q000627:therapeutic use; D001241:Aspirin / Q000627:therapeutic use; D003937:Diagnosis, Differential; D005260:Female; D005383:Finger Injuries / Q000150:complications* / Q000209:etiology; D005385:Fingers / Q000098:blood supply*; D051639:Gardening; D006686:Hobbies; D006801:Humans; D007511:Ischemia / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D018810:Magnetic Resonance Angiography; D008875:Middle Aged; D017762:Nadroparin / Q000627:therapeutic use; D017156:Photoplethysmography; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011674:Pulse; D017534:Radial Artery / Q000503:physiopathology; D012008:Recurrence; D012307:Risk Factors; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color; D014665:Vasodilator Agents / Q000627:therapeutic use
D000925:Anticoagulants; D017762:Nadroparin; D010975:Platelet Aggregation Inhibitors; D014665:Vasodilator Agents; D000527:Alprostadil; D001241:Aspirin
Akrale Durchblutungsstörungen bei einer Hobbygärtnerin: Rosenschneiden als vaskulärer Risikofaktor?