You could be forgiven for pointing the finger at Raynaud’s phenomenon as the cause of this patient’s patchy palm and digits, but the discolouration is actually down to a side effect of a steroid injection.

As it happens, the redness is the affected area in this case, as opposed to the characteristic white distal extremities of Raynaud’s.

The 43-year-old woman presented with a six-month history of mild weakness and progressive paresthesia in the thumb and index, middle and ring fingers of her left hand, consistent with carpal tunnel syndrome.

To treat the condition, the patient underwent a 0.33mL glucocorticoid injection in the left carpal tunnel before suddenly feeling an “odd sensation”.