Thrombosis or vasculitis – a common conundrum


This image shows a positive “Allen’s” test. It is from a case report that we published in Vascular Medicine journal last weekend. The left hand is pale due to a blood clot occluding the ulnar artery.

When blood clots (thromboses) occur in in unusual locations, a hunt must be undertaken to identify the underlying cause. The report describes a middle aged woman who developed clots in both of her forearm (ulnar) arteries after performing the downward dog manoeuvre during yoga. The initial ultrasound of the forearm arteries showed blood vessel inflammation around the clot raising the possibility of vasculitis. A thorough clinical assessment and further tests confirmed that the underlying cause was actually a blood clotting condition called antiphospholipid syndrome. She was started on a medication called warfarin to prevent further clots and has been well since.