Crutch induced axillary artery injury.

CASEREPORT A 53-year-old female presented with sudden onset of pallor and decreased sensation of the right hand and forearm, without loss of power. She had rheumatoid arthritis for the last 30 years, and had been using axillary crutches for the last 10 years. She had undergone bilateral knee and left hip replacements. There were no other significant cardiovascular risk factors, nor any previous history of deep venous thrombosis or miscarriages suggesting a hypercoagulable state. She was a non-smoker. On examination, she was in normal sinus rhythm. Both hands showed classical deformities ofburnt out rheumatoid arthritis. The right hand was cold and pale, with delayed capillary return. Sensation was impaired over the fingers. Right brachial, ulnar and radial pulses were absent.