We describe an infant presenting with intermittent discolouration and swelling of her fingers and toes occurring with changes in ambient temperature. Extensive investigations revealed raised inflammatory markers as well as sclerotic lesions within the phalanges and diffuse marrow oedema. Infectious and inflammatory causes were considered and excluded based on the clinical presentation and investigation findings. The persistence of symptoms prompted further investigation with MRI. Correlation of the MRI findings with previous case reports resulted in a diagnosis of microgeodic disease—an uncommon, self-limiting condition thought to be due to cold-induced vasospasm leading to avascular necrosis of the bone.
- Primary Care
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Contributors KFS cared for the patient, collected patient information and coauthored the report. GT cared for the patient, served as scientific advisor, critically reviewed and coauthored the report. NL served as scientific advisor, critically reviewed and coauthored the report. DB cared for the patient, collected patient information, served as scientific advisor, critically reviewed and coauthored the report.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.