Female, 21 years old. History of blue finger and thumb intermittently. TENDONS: There is a small amount of fluid within the extensor tendon sheaths, likely physiologic. BONES: There is no abnormal enhancement or bone marrow edema. No focal osseous lesions.ANGIOGRAM: The ulnar artery and the takeoff of the superficial palmar arch is well-opacified and normal in caliber. The common palmar digital arteries are patent proximally, however there is gradual tapering and the proper digital arteries are not well opacified distal to the bifurcation. The digital artery supplying the radial aspect of the fifth finger is well opacified distally, however the artery arising from the superficial palmar arch supplying the ulnar side of the fifth finger is communicated and poorly opacified.The radial artery gives rise to the deep palmar arch. The radial artery and deep palmar arch are patent but are diminutive in caliber. The princeps pollicis artery and the radial artery of the index finger arise from the deep palmar arch and are also diminutive, as are the metacarpal arteries through the ulnar aspect of the deep palmar arch.ADDITIONAL
Diminutive caliber of the radial artery, deep palmar arch, and metacarpal arteries, most severely involving the thumb and index finger. This can be related to vasospasm as can be seen with Raynaud's disease, less likely vasculitis or upstream chronic embolization. If more detailed evaluation is needed, further evaluation with conventional catheter angiography could be performed.