A 26-year-old man, who was previously fit and well was referred to the vascular surgical team with a painful right forearm 1 week after an aortic valve replacement for infective endocarditis (IE). He was an in-patient recovering from his cardiac surgery. He was on appropriate antibiotics for the IE. He had no systemic signs but had marked leucocytosis. Physical examination revealed a warm swollen painful right forearm with a more discrete pulsatile painful swelling in the mid-forearm measuring about 3×3 …