Compression of the dorsalis pedis artery: a novel cause of blue toe syndrome

Blue toe syndrome (BTS) is an important vascular condition characterized by painful blue discoloration of one or more digits. It is frequently due to emboli and is important because of the risk of progressive ischemia and tissue loss. A 53-year-old male presented with recurrent episodes of painful b...

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Bibliographic Details
Published in:Vascular 2012-12, Vol.20 (6), p.325-328
Main Authors: Griffin, K J, Rankine, J, Kessel, D, Berridge, D C, Scott, D J A
Format: Article
Language:English
Subjects:
Angiography, Digital Subtraction
Arterial Occlusive Diseases - diagnosis
Arterial Occlusive Diseases - etiology
Arterial Occlusive Diseases - therapy
Blue Toe Syndrome - diagnosis
Blue Toe Syndrome - etiology
Blue Toe Syndrome - therapy
Constriction, Pathologic
Embolism - diagnosis
Embolism - etiology
Embolism - therapy
Foot - blood supply
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Platelet Aggregation Inhibitors - therapeutic use
Recurrence
Tendons - abnormalities
Tendons - surgery
Tenotomy
Treatment Outcome
Ultrasonography, Doppler, Duplex
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Summary:Blue toe syndrome (BTS) is an important vascular condition characterized by painful blue discoloration of one or more digits. It is frequently due to emboli and is important because of the risk of progressive ischemia and tissue loss. A 53-year-old male presented with recurrent episodes of painful blue discoloration and blistering of the skin of the right hallux. On examination, the patient was found to have a cool, blue-purple great toe; all peripheral pulses were present. The patient was investigated for coagulopathy and potential sources of emboli, but the only abnormality was significant stenosis of the dorsalis pedis artery due to extrinsic compression by the extensor hallucis brevis tendon. In the absence of any other embolic source or abnormality, we believe that this case presents a novel and potentially remediable cause of BTS and indicates the need for a careful search for an underlying lesion when common causes of BTS have been excluded.
ISSN:1708-5381
1708-539X
DOI:10.1258/vasc.2011.cr0323