The patient, a 44-year-old woman with polymyositis, presented with a 1-day history of pain and bluish discoloration of the right index finger (A). Angiography revealed right radial artery occlusion at the wrist, with markedly diminished flow in the proper digital arteries (B). She subsequently developed acute respiratory distress syndrome requiring mechanical ventilation. However, she made a complete recovery. Digital infarcts showing microangiopathy have previously been reported to be associated with severe lung involvement and poor prognosis in patients with myositis (1).1