This week I saw a lady who has already lost one leg due to ischemia. Now her right foot has been “turning red” (her words) and she’s started sleeping in a chair due to foot pain. I showed her the way her foot changes color from dependency (photo 1) to elevation (photo 2). This color change takes only a few seconds.

Photo 1 is classic “ischemic rubor.” I thought I’d review exactly WHY dependency causes redness in some ischemic limbs and discovered that there’s debate about the mechanism of ischemic rubor. I think I found about three different explanations. Most of the literature focuses on the importance of recognizing this physical finding and its predictive value with regard to future limb loss, but I remain curious. I thought I’d let you guys explain the mechanism of ischemic rubor to me!

Dr. Fife sees patients at the CHI St. Luke's Hospital Wound Clinic in The Woodlands, Texas. For an appointment call (936) 266-2150.

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