Summary
Definition
History and exam
Key diagnostic 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 (dry gangrene)
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
- magnetic resonance angiogram of affected extremity
- plain radiography
Treatment algorithm
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 topic. 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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