A 21-year-old otherwise healthy woman presented with a 4-month history of pain in the fingertips of her left hand. She also reported color changes in the hand from red to white and then blue. One month before presentation she began having left shoulder pain and developed discolored spots on the palm of her left hand (Figure 1). She underwent a chest x-ray examination and arteriography of the left upper extremity (Figure 2).
Clinical photograph demonstrating multiple punctuate discolorations on the palmar surface of the left hand.
Digital subtraction angiogram of the left upper extremity showing aneurysmal dilation of the subclavian artery.
A. Raynaud phenomenon
B. Takayasu arteritis
C. Subclavian artery aneurysm
D. Subacute bacterial endocarditis
Caparrelli DJ, Tabulov DM, Freischlag JA. Image of the Month—Quiz Case. Arch Surg. 2006;141(5):513. doi:10.1001/archsurg.141.5.513-a