Presentation
Acral ischemia in a patient with polyarteritis nodosa.
Patient Data
Age: 70
Gender: Female
From the case:
Secondary Raynaud's phenomenon
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No detectable perfusion of the arteries of the 5th finger. String-of-beads appearance of the digital arteries II-IV with segmental stenoses. Narrowing of the ulnar artery in Guyon's canal.
Case Discussion
The "strings of beads" probably represent microaneurysms 1.
Although digital subtraction arteriography (DSA) is superior to MRA in acral perfusion disorders for its better temporal and spatial resolution, and the option to inject vasodilative agents, it is rarely indicated in patients with Raynaud's phenomenon.