EDITOR—We report the development of the hand-arm vibration syndrome in a 15 year old boy who presented with a two year history of painful hands. His hands became white and swollen when exposed to the cold and subsequently red and painful on warming. He had no clinical or laboratory features of an underlying connective tissue disorder.

The onset of his symptoms was preceded by the prolonged use of a widely available domestic computer game (Sony Playstation). He spent up to seven …