title: Painful black toe - a case study.
abstract: BACKGROUND
  Critical limb ischaemia refers to an advanced form of peripheral vascular disease where severe arterial occlusion manifests as chronic ischaemic rest pain, nonhealing ulcers and gangrene. Depending on the severity of disease and level of occlusion, endovascular revascularisation and vascular surgical bypass are indicated to salvage the limb before the inevitable lifesaving choice limb amputation.
  
  
  OBJECTIVE
  This article illustrates a clinical scenario in which, without any intervention, the ischaemic anatomy may dry up and mummify. It is a remarkable reminder of the natural history of such events.
  
  
  CONCLUSIONS
  Medical management including analgesia, wound care, infection control and aggressive modification of atherosclerotic risks factors may contribute to a better prognosis. For inoperable cases, pneumatic compression and spinal cord stimulation can be considered to relieve symptoms and improve wound healing.
authors.affiliation: Department of Family Medicine, Queen’s University, Kingston, Ontario, Canada. leungl@queensu.ca
authors.forename: Lawrence
authors.initials: L
authors.lastname: Leung
mesh_terms: D000368:Aged; D003937:Diagnosis, Differential; D005734:Gangrene / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D006801:Humans; D007511:Ischemia / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D023821:Limb Salvage; D008297:Male; D016491:Peripheral Vascular Diseases / Q000175:diagnosis; D014034:Toes / Q000098:blood supply* / Q000473:pathology