Extensive local necrosis following the intravenous use of X-ray contrast medium in the upper extremity

Local complications after the intravenous introduction of contrast media, though rare, are well recognized. Most of the reported cases of local soft tissue necrosis are related to leg phlebography. There is little information in the medical literature concerning the occurrence of such complications inthe upper extremity. Here, a case of severe soft tissue necrosis resulting from an intravenous injection of Conray 325* in the hand is presented. A girl of 6½ years was admitted into the Paediatric Unit of the Princess Margaret Hospital, Hong Kong because of acute nephritic syndrome which was later shown to be due to disseminated Lupus erythematosis. Steroid treatment was started in order to arrest its rapid progress. In order to outline the kidneys for renal biopsy, 20 c.c. of Conray 325 were injected into a vein over the dorsum of the girl's right hand, using a 21 -gauge metal scalp-vein needle.