Queen Elizabeth delighted royal fans today as she stood smiling and unaided in her first meeting since spraining her back.

But a picture showing her hands to be a shade of purple has sparked conversation about the 95-year-old monarch’s health – and whether the courtiers need to turn the heating on at Windsor Castle.

Her Majesty, who has been on doctors’ orders to rest for over a month, held a face-to-face audience on Wednesday with General Sir Nick Carter, the Chief of the Defence Staff.

In pictures released by Buckingham Palace, both the Queen and General Sir Carter’s hands look dark purple.

While it could just be the lighting in the room causing the effect, purple skin can be a sign of poor circulation.

This can happen in cold weather, which causes your blood vessels and arteries to narrow, restricting blood flow and reducing oxygen to the heart.

While it could just be the lighting in the room causing the effect, purple skin can be a sign of poor circulation.

This can happen in cold weather, which causes your blood vessels and arteries to narrow, restricting blood flow and reducing oxygen to the heart.

Dr Jay Verma, from the Shakespeare Medical Centre, told Metro.co.uk: ‘It might be Raynaud’s phenomenon or just really cold hands! The purple is due to deoxygenated blood.’

According the the NHS, Raynaud’s phenomenon is common and does not usually cause severe problems. It can be treated by keeping warm and will usually go away after a few minutes or hours.

The Queen has previously been pictured with a purplish blemish on her hands, when royals from Jordan came to visit back in 2019.

According to Dr Giuseppe Aragona, GP and Online Doctor for Prescription Doctor, there are several medical explanations for why the darker hue has returned.

He said: ‘There could be a few different reasons for why the Queen’s hands are so purple: a lack of circulation, frail skin, exposed veins, bruising, a leakage of blood to the tissue beneath the skin causing the colour.

‘It could be Cyanosis which occurs when there is not enough oxygen in the blood.

‘Blood which has a normal amount of oxygen is a deep red and means your skin is its normal colour, however low oxygenated blood is bluer which causes your skin to have a purple hue.

‘It is known that Cyanosis can develop quicker if the person has suffered a minor health problem, so this could be linked to her recent injury.’

Buckingham Palace confirmed in a last-minute announcement on Sunday that the Queen had sprained her back and would not be able to attend the Remembrance service at the Cenotaph.

The event, to pay tribute to the war dead, has long been one of the most important in the monarch’s calendar, and was widely expected to be her first public appearance after cancelling other engagements due to doctors’ advice.

Prince Charles, the future King, was teary-eyed during the service in central London as he laid a poppy wreath on behalf of his mother.

The Queen’s latest injury has sparked concerns over the impact of car journeys and longer periods of standing.

It followed another health scare last month, which saw the Queen staying in hospital overnight for the first time in eight years, forcing the cancellation of two trips.

Buckingham Palace said she had cancelled her plan to attend ‘with great regret’.

Today, Prince Charles insisted ‘the Queen is alright’ but said ‘it’s not as easy when you get to 95’.

Concern was briefly raised for his own health back in 2019, when he was pictured with swollen hands and feet during a tour of India.

Experts at the time said it could be caused by anything from water retention to poor circulation or even arthritis.

During a tour of Jordan today, Charles was asked by a journalist to send on their best wishes to the Queen after her recent bout of ill health.

The prince replied: ‘She’s alright, thank you very much.

‘Once you get to 95, it’s not quite as easy as it used to be. It’s bad enough at 73.’

Despite joking about his own age, Charles is among seven senior royals posed to step in and help the Queen as aides scale down her diary.

Prince Charles, his wife Camilla, Prince William and Kate, Princess Anne and Prince Edward and his wife Sophie are all understood to be aligned on helping out ‘for as long as is needed’.

The family members have been dubbed the ‘Magnificent 7’ by courtiers, who hope the ‘joint approach’ will give Her Majesty more time to recover before her Platinum Jubilee next year.