Blue limbs (the importance of history and examination)

BMJ 2004; 329 doi: (Published 05 August 2004) Cite this as: BMJ 2004;329:349
  1. Oana Predescu (, research fellow
  1. Northwick Park Hospital and Institute for Medical Research, Harrow

    I have come across an unusual hospital presentation of “blue limbs” three times in my years of practice, though the incidence in the population is likely to be high.

    As a surgical house officer, I encountered the condition twice within a couple of weeks. On the first occasion I was covering the wards when I was bleeped regarding a patient who had developed blue hands. A rare problem, I thought, and a number of possible medical and severe scenarios ran through my head. As I approached the ward, I expected to find a case of either Raynaud's syndrome or a rather ill patient, perhaps cyanosed or with superior vena cava …

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