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Author Credentials

Scott Suddarth, MD, West Virginia University Department of Physical Medicine and Rehabilitation, Physical Medicine and Rehabilitation Residency Program Matthew Epperly, MD, West Virginia University Department of Family Medicine, Assistant Professor Robert Levi Snedegar, MD, MBA, West Virginia University Department of Family Medicine, Assistant Professor

Author ORCID Identifier

0009-0002-7071-3121

Keywords

Raynaud Raynaud's phenomenon crush injury

Disciplines

Medicine and Health Sciences

Abstract

Raynaud’s phenomenon is a vasospastic disorder characterized by episodic vasoconstriction of the distal extremities, typically triggered by cold exposure or emotional stress. While primary Raynaud’s is usually symmetric, secondary forms may arise from systemic, vascular, or occupational causes potentially resulting in unilateral or asymmetric presentation. Post-traumatic Raynaud’s phenomenon is rarely reported and is generally limited to transient, distal involvement.

In this report, we present a 38-year-old female with Ehlers-Danlos Syndrome and Postural Orthostatic Tachycardia Syndrome (POTS) who developed unilateral Raynaud’s phenomenon following a crush injury to her right foot. She experienced intermittent discoloration and coldness extending to the mid-shin, occurring primarily while standing and worsening in cold environments. Examination during symptomatic episodes revealed the reported color change to the extremity as well as delayed capillary refill, while ankle-brachial indices and computed tomography angiography were normal. Vascular surgery diagnosed secondary Raynaud’s phenomenon, and conservative management was initiated. Consent was obtained from the patient prior to drafting the manuscript and publication.

This case highlights an atypical presentation of Raynaud’s phenomenon with unilateral, proximally extending, and position-dependent symptoms following acute trauma. Recognition of this entity is important, as normal vascular imaging does not exclude a functional microvascular disorder. Early diagnosis may prevent unnecessary testing and guide appropriate management, particularly in patients with underlying connective tissue or autonomic conditions.

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