Blue Toe Syndrome
The affected toes become cyanotic but there are other etiologies such as trauma, connective tissue disease like Scleroderma, hypercoagulability of blood as seen in polycythemia vera , atrial fibrillation and Raynauds phenomenon. In Raynauds the fingers will usually also be involved and this generally occurs in younger patients without any known history of atherosclerotic disease. At the local level, blue toe syndrome may occur in diabetic foot infections and those who have undergone foot surgery.
Blue toe syndrome is easily misdiagnosed because in most cases the larger arteries of the foot are palpable and that directs the doctor away from a diagnosis of occlusive disease. Treatment is geared towards alleviation of the blockage further up the arterial tree through stenting, bypass surgery, or anticoagulant therapy. Vasodilator drugs have no proven effectiveness in treatment of this condition, since this is not a vasospastic disorder. Mild forms of the disease which affect just the toes have a good prognosis and usually subside on their own. It should be noted that sometimes the pain in the toes is disproportional to the extent of involvement of the toes and adequate analgesics should be prescribed. Multi-systemic forms where the kidney is also usually affected, the prognosis is more dubious. In the foot, should the condition not resolve itself there is always the possibility that the condtion will worsen to gangrene and subsequent amputation of the affected toes.
Related Tags: diabetes, arthritis, walking, feet, foot pain, podiatrist, arteriosclerosis, shin splints
Dr. Mitnick is a foot specialist with over 25 years of clinical practice treating conditions of the foot, ankle and lower leg.
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