Carrying a heavy shopping bag can result in digital ischemia.
Mechanism: trauma from compression with secondary thrombosis
Clinical features:
(1) history of carrying a shopping bag
(2) onset of digital ischemia in a finger or fingers used to carry the bag, with pain and discoloration
(3) intravascular filling defects in the affected finger or fingers on angiography
(4) exclusion of vasculitis, emboli, and other causes
(5) improvement with anticoagulation and discontinuation of exposure
Mixed conditions might be possible and may be more likely if the temperature is cold (cryoglobulinemia, Raynaud's, vibration hand-arm syndrome).
Risk factors:
(1) smoking
(2) heavy load in the shopping bag
(3) prolonged compression of the affected finger
(4) narrow handles
(5) repeated episodes for carrying heavy shopping bags
(6) exposure to cold without gloves
(7) hypercoagulable state
