Mrs J presented to her general practitioner with polyarthralgia and pain and swelling of the middle three toes of the right foot. There was no relevant past medical history. The general practitioner made a diagnosis of Raynaud’s disease and referred her to hospital. The possibility of an underlying connective tissue disorder was raised and she underwent a series of investigations. During the course of these investigations, she went on to develop infection in the second and third toes. She received no specific treatment at this stage and her condition deteriorated rapidly. This culminated in her undergoing a right forefoot amputation.