Clubbing masquerading as a vascular malformation

A 13-year-old boy was referred to the radiology department with clinical suspicion of vascular malformation in the dorsum of the right great toe. The painless dark-coloured swelling was first noticed a year ago and had been gradually increasing. On examination, there was ~2×1.5 cm soft boggy warm, non-pulsatile swelling at the dorsum of the distal phalanx of the right great toe near the nail bed (figure 1A). Screening ultrasound showed ill-defined soft tissue thickening with increased colour vascularity (figure 1B). MRI was done …