Cold, painful hands prompts a referral to ED

Intense pain in the hands, aggravated by cooler temperatures prompts a GP to immediately refer this patient to the emergency department.
Sore finger hand
An examination of the capillary network in the nail bed reveals some clues.

Clarrie is a 21-year-old working full-time as a receptionist.

She presents with pain in her hands and fingers bilaterally, which has been worsening over the past week.