Raynaud’s phoenomenon, Raynaud’s disease, Raynaud’s syndrome

Hi Kitty cats

The phoenomenon is the description of the fingers going through the red,white and blue colour changes (named after French physician Maurice Raynaud (1834–1881) – who described this)

french flag

 

Raynaud’s syndrome, or “Secondary Raynaud’s”, occurs secondary to a wide variety of other conditions. Remember this because secondary and syndrome both begin with an ‘S’.

Raynaud’s disease is described as an allergy to the cold (not accurate but easy to remember) – disease….don’t know of any underlying cause

It is the “R” in the CREST syndrome acronym (Calcinosis, Raynaud’s, Esophagitis, Sclerodactyly, Telangiectasia) – this syndrome thought to be a limited version of Scleroderma which can produce a mouth which looks a little like a cat’s bottom

Coffman’s criteria for the diagnosis of primary Raynaud’s disease

• Intermittent vasospastic attacks (pallor, cyanosis and erythema) – precipitated by cold or emotional stimuli
• Symmetrical involvement of hands, fingers (feet and toes too, occasionally penis!)
• More than 2 years of symptoms
• No necrosis or skin changes
• Absence of underlying vessel disease
• Normal ESR, ANA, anti-centromere and anti-Scl 70 antibodies

Raynaud’s phenomenon

Raynaud's

 

In Raynaud‘s syndrome it is important to establish the cause (here are some if the many aetiological factors):

• Drugs, poisons, toxins (such as heavy metals like lead)
• Peripheral vascular disease
• Trauma
• Underlying collagen vascular disorder
• Cervical rib
• Lung tumour

Asymmetrical involvement and secondary skin change on examination are suggestive of secondary Raynaud’s syndrome.

Investigations are: FBC, ESR, ANA, ENA, anti-centromere antibodies and anti-Scl 70 antibodies

+ chest X-ray to exclude a cause in the lung apex (causing compression of the subclavian artery on it’s way into the arm)

Hope that was interesting

Dr B

Advertisement