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Images in emergency medicine
Limb loss following intra-arterial drug abuse
  1. Aoife N Keeling1,
  2. Rachel E Bell2,
  3. Tarun Sabharwal1
  1. 1Department of Interventional Radiology, St Thomas' Hospital, London, UK
  2. 2Department of Vascular Surgery, St Thomas' Hospital, London, UK
  1. Correspondence to Dr Aoife N Keeling, Department of Interventional Radiology, Guys and St Thomas NHS Trust Foundation, 1st Floor Lambeth Wing, St Thomas' Hospital, Lambeth Palace Road, London SE1 7EH, UK; aoifekeeling{at}hotmail.com

https://doi.org/10.1136/emj.2008.069104

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    A 40-year-old male intravenous drug misuser presented to the emergency department with a 1-month history of a painful swollen right lower limb. On examination, he was dehydrated, tachycardic and dyspnoeic. Multiple needle marks were identified within the right groin. Extreme right thigh tenderness was elicited on palpation and a fixed flexion deformity of the right hip was present. Laboratory indices revealed a markedly raised white cell count of 78.4×109/l, elevated creatinine of 277 μmol/l and a Staphylococcus …

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    Footnotes

    • Competing interests None.

    • Patient consent Obtained.