Last reviewed: November 2017
Last updated: October  2016

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • cold or numbness of affected extremity
  • pain during rewarming
  • purplish skin discoloration
  • white or yellow skin plaque
  • superficial skin vesiculation
  • deep purple blisters
  • tissue necrosis and mummification

Other diagnostic factors

  • erythema
  • joint dislocation
  • fractures

Risk factors

  • cold exposure
  • previous frostbite
  • vascular insufficiency
  • high altitude
  • hypoxia
  • alcohol
  • tobacco
  • dehydration
  • extremity trauma
  • constrictive clothing or equipment

Diagnostic investigations

Investigations to consider

  • technetium-99 pertechnetate scintigraphy
  • plain radiography
Full details

Emerging tests

  • MR angiogram of affected extremity
  • thermography and duplex imaging
Full details

Treatment algorithm

ACUTE

Contributors

Authors VIEW ALL

Attending Physician

Emergency Department

Medstar Southern Maryland Hospital Center

Sports Medicine Fellow

Georgetown University

Washington DC

Disclosures

EAK declares that she has no competing interests.

Director of Research, Development and Innovation

University Hospital Coventry and Warwickshire NHS Trust

Warwick Medical School

Coventry

UK

Disclosures

CI declares that he has no competing interests.

Professor

Division of Emergency Medicine

Department of Surgery

Stanford University School of Medicine

Palo Alto

CA

Disclosures

PSA declares that he has no competing interests.

Professor Christopher Imray, Dr Paul S. Auerbach, and Dr Elizabeth A. Kaufman would like to gratefully acknowledge Dr Claire Turchi, a previous contributor to this monograph. CT declares that she has no competing interests.

Peer reviewers VIEW ALL

Medical Director

Yellowstone National Park

WY

Founder/Director

Everest Base Camp Medical Clinic

Nepal

Disclosures

LF declares that she has no competing interests.

Clinical Assistant Professor of Surgery and Emergency Medicine

Associate Director Wilderness Medicine Fellowship

Assistant Research Director

Stanford University School of Medicine

Palo Alto

CA

Disclosures

GSL declares that he has no competing interests.

Director

Institute for Altitude Medicine

Telluride

CO

Disclosures

PH declares that he has no competing interests.

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