Although Raynaud's phenomenon is a well-known consequence of exposure to cold, neither its incidence in recreational divers nor case reports in that population have been reported in the medical literature. We present a case report of the initial manifestation of primary Raynaud's phenomenon during a warm-water scuba dive. A healthy 18-year-old Caucasian male made four open-circuit compressed air scuba dives over two days in the Florida Keys to a maximum depth of 90 feet. After two of those dives, he noted painless, blue discoloration on three digits of his left hand, unaccompanied by sensory changes, which resolved within an hour of surfacing. During a fitness-to-dive evaluation one week later, his physical examination was normal. No skin discoloration, neurological symptoms or changes to pulse or blood pressure were noted with temperature or positional provocation. Laboratory testing was normal. However, arterial Doppler measurements were severely diminished in all digits of both upper extremities with temperature provocation, and continued to be diminished five minutes after immersion, suggesting Raynaud's phenomenon.
Keywords: Raynaud's phenomenon; blue fingers; recreational diving; thoracic outlet syndrome.
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