Updated: 4/24/2016

Vascular Evaluation of the Hand

Review Topic
  • Three-phase bone scan
    • Phase I (2 minutes)
      • shows an extremity anteriogram
    • Phase II (5-10 minutes)
      • shows cellulits and synovial inflammation
    • Phase III (2-3 hours)
      • shows bone images
      • RSD diagnosed with positive phase III that does not correlate with positive Phase I and Phase II
    • Phase IV (24 hours)
      • can differentiate osteomyelitis from adjacent cellulitis
  • Duplex scan
    • is helpful for arterial intimal lesions (true and false aneurysms)
  • Arteriogram  
    • remains gold standard for embolic disease
    • downside is it is invasive with risks
  • Ultrasound duplex
    • imaging is becoming more sensitive and specific
  • Segmental limb pressures



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