Materiały źródłowe

• #1 Raynaud’s disease – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/raynauds-disease/diagnosis-treatment/drc-20363572

  Your healthcare professional asks about your symptoms and medical history and does a physical exam. You also might have tests to rule out other medical problems that can cause the same symptoms. […] A test called nailfold capillaroscopy can tell the difference between primary and secondary Raynaud’s. During the test, the professional uses a microscope or magnifier to look for anything unusual on the skin at the base of a fingernail. This might include swelling of the blood vessels. […] Blood tests can help find out whether another condition, such as an autoimmune condition or a connective tissue disease, is causing Raynaud’s. Blood tests for Raynaud’s might include: […] No one blood test can diagnose Raynaud’s. Other tests, such as those that rule out diseases of the blood vessels, can help find a condition that can be related to Raynaud’s.

• #1 Primary Raynaud Phenomenon | AAFP

  https://www.aafp.org/pubs/afp/issues/2014/0915/p403.html

  Raynaud phenomenon is an episodic, reversible vasospasm of the peripheral arteries, usually digital. […] The diagnosis of Raynaud phenomenon is by a history of clearly demarcated pallor of one or more digits, followed by at least one other color change (cyanosis, erythema), which is usually precipitated by cold. A history, physical examination, and laboratory results can help rule out secondary Raynaud phenomenon. […] Laboratory testing may include full blood count, erythrocyte sedimentation rate, and antinuclear antibodies with pattern if connective tissue diseases are suspected. Magnification of the nail beds to observe abnormal capillaries is also important to rule out Raynaud phenomenon associated with connective tissue diseases.

• #1 Raynaud’s Syndrome | Diagnosis & Disease Information

  https://www.rheumatologyadvisor.com/ddi/raynauds-syndrome/

  Raynauds syndrome is primarily a clinical diagnosis. The patient often self-reports symptoms because they typically occur episodically, rather than during an office visit. Elements of the patients history should include the age of onset, location of affected areas, presence of symmetry, presence of digital ulcerations, and severity of the attacks. Because primary Raynaud syndrome occurs as a response to stimuli, such as cold or emotional stress, the patients history should also include an assessment of aggravating factors. […] Diagnosis typically requires a description of at least two (biphasic) color changes of the digits. Usually these attacks begin with one finger and spread to the others but spare the thumb. If the thumb is involved, secondary Raynaud syndrome is more likely. […] A positive response to all 3 questions of the Raynauds syndrome screening typically confirms the diagnosis: Are your fingers sensitive to cold? Do your fingers change color when they are exposed to cold temperatures? Do your fingers turn white, blue, or both?

• #1 Raynaud’s Phenomenon: Causes, Signs, and Treatment

  https://www.verywellhealth.com/raynauds-phenomenon-8643512

  How Raynauds Phenomenon Is Diagnosed […] There is no single test to diagnose Raynauds. Instead, a healthcare provider will go through a process to determine if you have Raynauds. If the diagnosis is positive, your provider will distinguish whether it is primary or secondary Raynauds. […] A healthcare provider will conduct a physical exam to look for any permanent damage caused by Raynauds such as sores on the fingers or gangrene. […] A full medical history is often the most telling part of the diagnostic process. […] A healthcare provider will ask for details of Raynauds attacks, their frequency and location and how long they last to establish an increased sensitivity to cold and a history of experiencing discoloration of the fingers or affected areas. […] Diagnostic tests can help distinguish between primary and secondary Raynauds. A nailfold capillary microscopy test looks at the small blood vessels in the nails. Changes in these capillaries can be a sign of secondary Raynauds.

• #1 Raynaud’s Disease (Causes, Symptoms and Treatment)

  https://patient.info/doctor/raynauds-phenomenon-pro

  Raynaud’s disease is characterised by a paroxysmal vasospastic and subsequent vasodilatory chain of events affecting peripheral arterioles, usually in the hands and feet. […] The pathogenesis of Raynaud’s disease is complex but abnormalities of the blood vessel wall, of neural control mechanisms and of intravascular circulating factors are known to interact and contribute. […] The patient may initially notice pallor of the distal portion of one or more digits. […] It is important to take an occupational history and specifically ask about the use of vibrating tools at work or at home. […] In primary Raynaud’s disease there will usually be nothing to find, as patients rarely present during the event. […] To detect evidence of an alternative cause for the symptoms, or an underlying disease associated with secondary Raynaud’s disease, look for any abnormality in pulses of the affected hand/foot.

• #1 The pathogenesis, diagnosis and treatment of Raynaud phenomenon | Nature Reviews Rheumatology

  https://www.nature.com/articles/nrrheum.2012.96

  The past 10 years have seen the publication of results from several multicentre clinical trials in primary and systemic sclerosis (SSc)-related Raynaud phenomenon. […] The main advances in diagnosis have been a clearer understanding of autoantibodies and of abnormal nailfold capillary patterns as independent predictors of SSc, and widespread use and increased availability of capillaroscopy. […] In patients with Raynaud phenomenon, presence of SSc-specific autoantibodies and abnormal nailfold capillary pattern are independent predictors of an underlying SSc-spectrum disorder. […] New treatment approaches for Raynaud phenomenon include phosphodiesterase inhibitors and, for patients with SSc and recurrent digital ulcers, endothelin-1 receptor antagonists.

• #1 Raynaud Phenomenon Workup: Approach Considerations, Laboratory Studies, Magnetic Resonance Imaging

  https://emedicine.medscape.com/article/331197-workup

  Raynaud phenomenon can be diagnosed on clinical grounds. Laboratory testing is necessary to assess for conditions that can mimic Raynaud phenomenon or cause secondary Raynaud phenomenon. The selection of tests should be guided by the clinical findings. […] Nailfold capillaroscopy is the gold standard for differentiating primary Raynaud phenomenon from secondary Raynaud phenomenon (in particular, for identifying a scleroderma pattern). European guidelines note that capillaroscopy is not often performed in primary care, but recommend its use in secondary care, as abnormal capillary patterns are strong predictors of connective tissue disease. […] Magnetic resonance imaging has been studied in some forms of secondary Raynaud phenomenon. […] Smitaman and colleagues report that magnetic resonance imaging (MRI) scans of the feet of patients with Raynaud phenomenon demonstrate a progressive distal-to-proximal pattern of phalangeal bone marrow edema. They suggest that this finding may allow early diagnosis and treatment of rheumatologic disorders that may be associated with Raynaud phenomenon. […] Using cardiac MRI, Quarta et al demonstrated the presence of cold-induced cardiac ischemia in patients with systemic sclerosis and secondary Raynaud phenomenon, and showed that therapy with iloprost can reduce episodes of cardiac Raynaud phenomenon.

• #1 Cold Stimulation Test: MedlinePlus Medical TestLock

  https://medlineplus.gov/lab-tests/cold-stimulation-test/

  A cold stimulation test involves placing your fingers in ice water and checking to see how long it takes your skin to return to a normal temperature. This test is used to find out if you have Raynaud phenomenon. […] Your provider will usually diagnose Raynaud phenomenon by doing a physical exam and reviewing your symptoms and medical history. Some providers also use a cold stimulation test to help confirm your diagnosis of Raynaud phenomenon. […] You may need this test if you have symptoms of Raynaud phenomenon. Its symptoms usually show up after exposure to cold or emotional stress. […] If it takes 20 minutes or more for your finger temperature to return to normal after the ice water bath, it probably means you have Raynaud phenomenon. If your symptoms are severe and/or you are age 35 or older, you may have secondary Raynaud phenomenon. […] If your health care provider thinks you have secondary Raynaud phenomenon, they may order more tests to help diagnose the disorder that is causing it.

• #1

  https://umiamihealth.org/en/treatments-and-services/arthritis-(rheumatology)-/raynauds-phenomenon

  Raynauds phenomenon causes blood vessels in your extremities to narrow in cold temperatures or during emotional excitement or stress called a Raynauds attack. Most often, it occurs in your hands, fingers, feet, or toes, but it can also affect your lips, tongue, nose, or chin. […] Rheumatologists at University of Miami Health System offer expert diagnosis and treatment of Raynaud’s phenomenon. With locations throughout South Florida, you can get complete care nearby. […] Cold Stimulation Test This test brings on Raynaud’s symptoms and measures your response to cold temperatures. A small temperature measurement device is attached to your fingers, which are submerged briefly in ice water. The device measures how long it takes for your fingers to return to a normal temperature. For those with Raynaud’s, it can take more than 20 minutes to warm up.

• #1

  https://viasonix.com/vascular-angiology/raynauds-syndrome/

  To diagnose Raynauds Disease, physiological tests are typically performed. Such tests include measuring of photoplethysmography (PPG) waveforms with or without blood pressure in the fingers or toes, both at room temperature and after cold immersion. […] This step-by-step guide for performing a Raynauds test is for informational purposes only. Healthcare professionals should rely on their expertise, clinical judgment, and institutional protocols for accurate administration and interpretation. Additional clinical information, patient history, physical examination, and other diagnostic tests may be necessary for comprehensive evaluation. […] During a Raynauds Syndrome test, several expected results and observations can be noted. First, during the cold immersion phase, the affected area may exhibit color changes, turning white or blue due to vasoconstriction and reduced blood flow. This discoloration serves as a characteristic sign of Raynauds Syndrome.

• #1

  https://viasonix.com/vascular-angiology/raynauds-syndrome/

  Additionally, the focus of the test is on the time it takes for the PPG waveforms to return to their pre-immersion amplitude levels after exposure to cold temperatures. […] It is expected that the PPG waveforms will gradually recover and return to their baseline levels within approximately 10 minutes or so. This recovery time can vary depending on individual factors and the severity of the condition. A longer duration for the waveforms to return to pre-immersion levels may indicate the presence of a disease condition related to Raynauds Phenomenon. […] Systolic blood pressure measurements can provide further insights into the diagnosis. In cases of secondary Raynauds, a decrease in systolic blood pressure compared to primary Raynauds is typically observed. This difference in blood pressure readings can help distinguish between primary and secondary forms of the condition.

• #1 Raynaud’s phenomenon – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/193

  Raynaud’s phenomenon (RP) is common, affecting between 3% and 5% of the population. […] The diagnosis is made clinically: digits turn white (pallor) then blue with deoxygenation and/or red with reperfusion; pallor is well demarcated. […] Key diagnostic factors include presence of risk factors, digit pain/discomfort, digital paraesthesia, pallor of digits, red and/or blue discoloration of digits, dilated capillaries at nailbeds, well-defined discoloration, and magnification of nailbeds. […] 1st investigations to order include clinical diagnosis, antinuclear antibody, FBC, erythrocyte sedimentation rate, C-reactive protein, and urinalysis.

• #1 Raynaud’s Disease: Types, Symptoms, Diagnosis, & Treatment

  https://www.artemishospitals.com/blog/raynaud-s-disease-types-symptoms-diagnosis-treatment

  Raynauds Disease Diagnosis […] A doctor diagnoses Raynauds disease based on an individuals symptoms. A few diagnostic tests that a doctor may recommend to determine primary or secondary Raynauds syndrome and its causes are: […] CBC (Complete Blood Count): Blood test that checks for a range of conditions. […] ESR (Erythrocyte Sedimentation Test): Blood test that checks for inflammation in the body. […] Urinalysis: Urine test that detects a range of conditions linked to Raynauds disease. […] Pulse volume recording: A type of non-invasive test that checks the blood flow in the arms and legs. […] RF (Rheumatoid Factor) test: Blood test that checks for autoimmune diseases.

• #1 Raynaud’s Syndrome | Diagnosis & Disease Information

  https://www.rheumatologyadvisor.com/ddi/raynauds-syndrome/

  The workup may also include laboratory investigations, which should be tailored to the clinical findings. Examples of relevant studies include a complete blood count, comprehensive metabolic panel, rheumatoid factor, anti-cyclic citrullinated peptide, thyroid studies, hepatitis screening, anti-neutrophil cytoplasmic antibodies, and antiphospholipid antibodies. […] The minimal set of investigations should include nailfold capillary microscopy, complete blood count, erythrocyte sedimentation rate (ESR), and ANA.

• #1 Raynaud’s Phenomenon: A Common Sense Approach to Diagnosis and Management

  https://practicingclinicians.com/the-exchange/raynaud-s-phenomenon-a-common-sense-approach-to-diagnosis-and-management

  Raynaud’s phenomenon (RP) is all too common in New England during the colder months of the year. […] In the workup of a patient with Raynaud’s who has clinical evidence of systemic autoimmune disease, laboratory studies should include antinuclear antibodies (ANA), looking for a nucleolar pattern, anti-centromere, and anti-topoisomerase (ScL-70, IgG, and IgA – rarely IgM) antibodies. […] It is also useful to utilize nailfold capillary microscopy; this is performed with an ophthalmoscope using a diopter setting of 40 and an immersion oil droplet placed on the cuticle. […] Many patients with underlying rheumatic disease use calcium channel blockers (CCBs), which cause peripheral vasodilation, thereby preventing vasospasm. […] If patients fail to respond to CCBs, direct vasodilators may be helpful. […] Surgical options are available for those who are refractory to chemical intervention. […] For those not responsive to these lifestyle interventions, CCBs are often effective and safe.

• #1 Raynaud Phenomenon: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/331197-overview

  Raynaud phenomenon manifests as recurrent vasospasm of the fingers and toes that usually occurs in response to cold exposure or stress. […] Diagnostic criteria for primary Raynaud phenomenon include the following: Attacks triggered by exposure to cold and/or stress, Symmetric bilateral involvement, Absence of necrosis, Absence of a detectable underlying cause, Normal nailfold capillaroscopy findings, Normal laboratory findings for inflammation, Absence of antinuclear factors. […] For primary Raynaud phenomenon, the first line of therapy consists of lifestyle measures. If these prove inadequate, the patient may benefit from pharmacologic treatment. […] Therapy for secondary Raynaud phenomenon must be tailored to the underlying disorder. Patients with secondary Raynaud phenomenon are more likely to require pharmacologic therapy. A variety of drugs are used off-label for treatment: calcium channel blockers (especially nifedipine) are the most common choice; other drug classes include topical nitrates, phosphodiesterase 5 inhibitors, and endothelin antagonists.

• #1 Raynaud’s disease – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/raynauds-disease/symptoms-causes/syc-20363571

  Secondary Raynaud’s. Also called Raynaud’s phenomenon, this form develops because of another health condition. […] Symptoms of secondary Raynaud’s usually appear around age 40. That’s later than symptoms appear for primary Raynaud’s. […] Causes of secondary Raynaud’s include: Connective tissue diseases. Most people who have a rare disease that leads to hardening and scarring of the skin, known as scleroderma, have Raynaud’s. […] Risk factors for primary Raynaud’s include: Sex assigned at birth. The condition affects more women than men. […] Risk factors for secondary Raynaud’s include: Certain diseases. These include conditions such as scleroderma and lupus. […] If secondary Raynaud’s is severe, reduced blood flow to fingers or toes could cause tissue damage. But that’s rare. […] A completely blocked blood vessel can lead to skin sores or dead tissue. This can be difficult to treat. Rarely, very bad untreated instances might require removing the affected part of the body.

• #1 Raynaud’s Syndrome | Diagnosis & Disease Information

  https://www.rheumatologyadvisor.com/ddi/raynauds-syndrome/

  Referral to rheumatology for further evaluation is recommended to differentiate between primary and secondary Raynaud syndrome. Age may suggest primary or secondary etiology, as those with primary Raynaud syndrome typically develop symptoms between age 15 and 25. […] Features that should prompt consideration of secondary Raynaud syndrome include being male, first developing symptoms after age 30, signs of tissue ischemia, abnormal laboratory parameters that suggest another disease, and having unilateral symptoms. […] A rheumatologist typically performs the detailed diagnostic workup to differentiate primary and secondary Raynaud syndrome. This is due to the possible connective tissue disease etiologies of Raynaud syndrome. […] A nailfold capillary microscopy analysis of microvascular and morphologic changes in peripheral vessels is a non-invasive way to differentiate between primary and secondary Raynaud syndrome.

• #1 Raynaud Syndrome – Cardiovascular Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/cardiovascular-disorders/peripheral-arterial-disorders/raynaud-syndrome

  Findings suggesting secondary Raynaud syndrome are the following: Age at onset 30 years, Severe painful attacks that may be asymmetric and unilateral, Ischemic lesions, History and findings suggesting an accompanying disorder. […] Vascular laboratory testing includes measuring digital pulse wave forms and pressures. […] The main blood tests are to diagnose collagen vascular diseases (eg, measurement of erythrocyte sedimentation rate [ESR] or C-reactive protein, antinuclear and anti-DNA antibodies, rheumatoid factor, anticentromere antibody, anti-cyclic citrullinated peptide [CCP] antibodies, anti-scleroderma [SCL] 70 antibody). […] Diagnose clinically but consider testing to diagnose a suspected cause.

• #1 Raynaud’s Phenomenon or Disease Treatment & Types | NIAMS

  https://www.niams.nih.gov/health-topics/raynauds-phenomenon/basics/diagnosis-treatment-and-steps-to-take

  There are two types of Raynauds phenomenonprimary and secondary. The diagnosis between the two types is most commonly made with a device called nailfold capillaroscopy, where the doctor looks at your skin at the bottom of your fingernails under a microscope. […] The treatment depends on how serious the condition is and whether it is the primary or secondary form. […] The secondary form of Raynauds phenomenon occurs in combination with another disease or an environmental exposure. […] The secondary form is less common but typically more serious than the primary form due to damage that occurs to the blood vessels. […] In secondary Raynauds phenomenon, damage to the blood vessels from certain diseases, such as lupus or scleroderma, or work-related exposures are associated with the condition.

• #1 ¿Qué es el síndrome de Raynaud? Síntomas y tratamientos

  https://elgeaditraumatologia.com/en/enfermedad-raynaud-gravedad-causas-tratamiento/

  Raynaud’s syndrome is a condition characterized by episodes of spasm in the fingers of the hands and sometimes on the toes. […] Raynaud’s syndrome is a vascular condition in which a spasm occurs in the blood vessels in the fingers of the hands. and, on some occasions, the feet. This spasm decreases blood flow and causes a variety of skin changes, such as paleness, cyanosis, and redness, as well as a feeling of cold and numbness in the affected fingers. […] The exact cause of Raynaud’s syndrome is still unknown., it is known that there are several factors that can trigger episodes, such as cold, stress and some autoimmune diseases. […] To carry out the diagnosis of Raynaud’s syndrome, the doctor will perform a physical examination and may ask questions about symptoms and possible triggers. Additionally, your doctor may perform tests to rule out other medical conditions that may have similar symptoms, such as peripheral arterial disease or carpal tunnel syndrome.

• #1 Raynaud Disease | Riley Children’s Health

  https://www.rileychildrens.org/health-info/raynaud-disease

  Raynaud disease is the tendency of cold temperatures and anxiety to trigger spasms in the arteries of the arms and legs, which causes skin discoloration and discomfort. […] If you believe your child may have Raynaud disease, you should seek the evaluation of a pediatric rheumatologist who can make a correct diagnosis: Many teens have hyper-reactivity of their blood vessels that is less severe and does not lead to tissue injury. This is called acrocyanosis, and it is not harmful. […] In diagnosing Raynaud disease, your child’s doctor will determine if there is an underlying immune disease causing the condition, which is known as secondary Raynaud phenomenon. If your child has no underlying medical condition causing this condition, then he or she is said to have primary Raynaud disease. Because there is no single blood test that can help your child’s doctor pinpoint Raynaud specifically, one or more of the following tests may be performed to determine if your child has a related or underlying condition:

• #1 Raynaud’s Disease Clinic – Brigham and Women’s Hospital

  https://www.brighamandwomens.org/medicine/rheumatology-inflammation-immunity/services/raynauds-disease-clinic

  Patients at our Raynauds Disease Clinic are initially evaluated by two physicians a vascular medicine specialist and a rheumatologist. Much of the diagnosis will focus on evaluating symptoms. Along with a complete medical history and a medical exam, our team will typically order at least one type of blood test. A patient also may undergo a cold challenge test to bring out color changes in the hands or feet. […] With Secondary Raynauds phenomenon, its also important to identify and treat the underlying autoimmune or other disorder that may be causing Raynauds phenomenon.

• #1 Raynaud’s Syndrome | UCSF Department of Surgery

  https://surgery.ucsf.edu/condition/raynauds-syndrome

  Your doctor may ask about your risk factors for Raynaud’s. He or she also may ask about your signs and symptoms when you’re exposed to cold temperatures or stress. […] Your doctor will look at your fingers and toes to check the health of your skin and nails and to check blood flow to these areas. […] Your doctor may recommend the following tests to check for Raynaud’s and related conditions: […] A cold stimulation test can be used to trigger Raynaud’s symptoms. […] Your hands are then removed from the cold, and the device measures how quickly your fingers return to their normal temperature. […] If you have Raynaud’s, it may take more than 20 minutes for your fingers to return to their normal temperature. […] You may have a test called nailfold capillaroscopy. […] If your doctor sees abnormal arteries, it may mean you have a disease linked to Raynaud’s, such as scleroderma. […] Your doctor may order blood tests to look for conditions that are linked to secondary Raynaud’s.

• #1 Raynaud’s Disease – familydoctor.org

  https://familydoctor.org/condition/raynauds-disease/

  Raynaud’s disease is a rare condition. It is a temporary narrowing of your blood vessels caused by spasm. The condition affects the blood to your skin, mainly to your fingers and toes. It is sometimes called Raynaud’s phenomenon or syndrome. […] Your doctor will do a physical exam and review your symptoms. Tell your doctor if episodes occur more when you are cold and/or stressed. Your doctor may trigger an episode using cold water or air to see your response. He or she also will ask if Raynaud’s or related health issues run in your family. Your doctor may check the blood vessels in your fingernails. Blood tests can help identify the type of the disease or other issues that cause your symptoms.

• #1 Raynaud’s Syndrome: Symptoms, Causes, Diagnosis, Treatment, and Prevention

  https://www.everydayhealth.com/blood-disorders/raynauds-syndrome/

  How Is Raynauds Disease Diagnosed? If youre grappling with symptoms, talk to your healthcare provider to get diagnosed. He or she may refer you to a rheumatologist or vascular medicine subspecialist, Chawla says. Its a clinical diagnosis, meaning its diagnosed by the clinician based on history and an exam. Taking photographs or videos of your Raynauds attacks and keeping a diary of your symptoms to show your doctor can help in expediting a diagnosis, Chawla says. […] Your doctor may also conduct a cold challenge test to check for color changes in the hands and fingers, Furst notes. We ask patients to put their hands into ice water and hold it for 90 seconds. And sometimes that brings it on. […] Doctors then conduct a capillaroscopy, which looks at the tiniest blood vessels at the base of the fingers. That can give us a hint as to whether someone might have secondary Raynauds.

• #1 Raynaud Phenomenon | Boston Children’s Hospital

  https://www.childrenshospital.org/conditions/raynaud-phenomenon

  Primary Raynauds phenomenon is often diagnosed by general practitioners. Your childs doctor will ask about his medical history and symptoms and do a physical exam to help rule out more common ailments like chilblains (cold-induced sores at the tips of digits) or a pinched nerve. […] Its fairly simple to determine if someone has Raynauds phenomenon, but its tricky to sort out primary from secondary (whose underlying cause can be difficult to spot). […] If your pediatrician is concerned your child may have secondary Raynauds, she may refer him to a rheumatologist (a specialist in treating immune-mediated diseases of the joints, blood vessels, and muscles). Rheumatologists are experts on the autoimmune diseases that cause secondary Raynauds, like scleroderma and lupus. […] Tests to determine whether your childs Raynauds is primary or secondary include: Nailfold capillaroscopy: An in-office test where the doctor uses a microscope or other magnifying device to look at the capillaries (tiny blood vessels) at the base of your childs fingernail. Enlarged or irregular capillaries can be a sign of certain autoimmune diseases. Antinuclear antibody test (ANA): A lab test that checks your childs blood for the presence of antinuclear antibodies, which are a kind of protein that attacks the bodys own cells. Most autoimmune diseases that occur with secondary Raynauds are ANA positive, but many patients with a positive ANA are healthy and will remain so. Erythrocyte sedimentation rate (ESR or sed rate): A lab test that measures how quickly red blood cells fall to the bottom of a test tube. If the cells to clump together and fall more rapidly than normal, it can signal there is inflammation somewhere in your childs body which is sometimes a marker of autoimmune disease. […] After we complete all necessary tests, our experts meet to review and discuss what they have learned about your child’s condition. Then we will meet with you and your family to discuss the results and outline the best next steps.

• #1 Raynaud’s Phenomenon

  https://rheumatology.org/patients/raynauds-phenomenon

  Raynauds Phenomenon (RP) results when there is a decrease in blood flow to the fingers and toes when someone is exposed to cold weather or stress, due to an exaggerated constriction in blood vessels. […] Rheumatologists help to differentiate whether Raynauds is primary or secondary in nature. […] If symptoms last for hours or are persistent despite attempts at rewarming, this can suggest more serious disease. […] Patients with severe Raynauds can develop ulcerations on their fingertips or toes due to tissue death resulting from lack of blood flow. […] Medications such as calcium channel blockers (amlodipine, nifedipine, felodipine, and others) and angiotensin-receptor blockers increase blood flow to the fingers and toes. […] For patients with more severe symptoms or who have developed complications such as ulcers, other medications can be used including sildenafil or prostacyclins. […] Individuals should consult a qualified health care provider for professional medical advice, diagnosis and treatment of a medical or health condition.

• #1 Raynaud’s Phenomenon: A Current Update on Pathogenesis, Diagnostic Workup, and Treatment

  https://www.vsijournal.org/journal/view.html?uid=1349&vmd=Full

  Several diagnostic criteria for RP exist, with some minor variations. All criteria share the core principle of requiring cold-induced digital skin color changes. […] Normal nailfold capillaroscopy is a crucial imaging tool that provides detailed information about the structural condition of capillaries in the nail folds. […] Although a normal NFC finding typically suggests primary RP, distinguishing between normal and abnormal images, and further classifying abnormal patterns as scleroderma or non-scleroderma, can be challenging. […] The treatment of patients with RP and critical ischemia of the digits should always prioritize ruling out other vaso-occlusive conditions that may necessitate interventional procedures. […] Calcium channel blockers (CCB) are the first-line vasodilator medications used for RP management.

• #1 Raynaud’s phenomenon – Rheumatology | Northwell Health

  https://www.northwell.edu/rheumatology/conditions/raynauds-phenomenon

  How is it diagnosed? […] There are no specific laboratory tests that can confirm a diagnosis of Raynaud’s phenomenon. Instead, diagnosis is usually based on reported symptoms. Your doctor may perform a cold challenge test to bring out color changes in the hands or a nailfold capillaroscopy where your fingernail is examined under a microscope. […] Tests to determine which form (primary or secondary) of Raynaud’s phenomenon a patient may have include a medical exam, blood tests and a complete medical history.

• #1 Raynaud’s Phenomenon: A Current Update on Pathogenesis, Diagnostic Workup, and Treatment

  https://www.vsijournal.org/journal/view.html?uid=1349&vmd=Full

  Raynauds phenomenon (RP) is a condition characterized by episodic, excessive vasoconstriction in the fingers and toes, triggered by cold or stress. […] Diagnosis of RP is primarily clinical. Recent advancements in imaging techniques have aided in diagnosis and monitoring, but nail fold capillaroscopy remains the gold standard for distinguishing between primary and secondary RP. […] Raynauds phenomenon is a clinically diagnosed condition with heterogeneous causes. Due to its heterogeneity, a comprehensive evaluation to rule out potential underlying causes is crucial. […] Clinical history and physical examination are the cornerstones of diagnosis. […] Generally, a diagnosis of primary RP requires fulfilling specific criteria, including no underlying CTDs, normal physical examination findings, a normal NFC test, a negative or low-titer ESR, and an ANA titer 1:40.

• #1 Raynaud Phenomenon: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/331197-overview

  The prognosis for patients with primary Raynaud phenomenon is usually very good, with no mortality and little morbidity. […] The prognosis for patients with secondary Raynaud phenomenon is related to the underlying disease. The prognosis for the involved digit or digits in these patients is related to the severity of the ischemia and the effectiveness of maneuvers to restore blood flow.

• #2 Raynaud’s Phenomenon: Diagnosis, Treatment, and Steps to Take

  https://www.niams.nih.gov/health-topics/raynauds-phenomenon/diagnosis-treatment-and-steps-to-take

  There is no single test to diagnose Raynauds phenomenon. Doctors usually diagnose it based on symptoms, in particular, on a description of a typical attack upon exposure to cold. Your doctor will likely also take a medical history and perform a physical exam. […] Your doctor may perform additional tests to distinguish between the two forms of the condition. These include: […] Nailfold capillaroscopy. During this test your doctor uses a magnifier to look at the base of your fingernails for signs of changes in capillaries (tiny blood vessels), a sign of secondary Raynauds phenomenon. […] Blood tests. If your doctor suspects that you have the secondary form, they may order blood tests that may indicate you have a disease that has been linked to Raynauds phenomenon, such as lupus or scleroderma. One of the more common of these tests is the antinuclear antibody (ANA) test and a thyroid stimulating hormone (TSH) test.

• #2 Patient education: Raynaud phenomenon (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/raynaud-phenomenon-beyond-the-basics

  Raynaud phenomenon (RP) is diagnosed based on the person’s description of a typical attack following cold exposure. […] It is most important to have a full evaluation by a health care provider to determine if RP is happening and the underlying cause of the RP. This requires a good history and physical examination and laboratory testing that may include blood tests and, on occasion, special studies of the blood vessels and their function.

• #2 Raynaud’s Disease | Arthritis Foundation

  https://www.arthritis.org/diseases/raynaud-s-disease

  Fingers and toes that are always cold could be a sign of Raynaud’s. […] A primary care doctor can usually determine if you have Raynauds disease by getting a medical history and description of an attack and doing a physical exam. Your doctor may examine your fingers under magnification to look for abnormal blood vessels in the skin. Sometimes special blood tests may be needed to distinguish primary from secondary Raynauds. These tests look for evidence of an autoimmune or connective tissue disease.

• #2 Raynaud Phenomenon Workup: Approach Considerations, Laboratory Studies, Magnetic Resonance Imaging

  https://emedicine.medscape.com/article/331197-workup

  Raynaud phenomenon can be diagnosed on clinical grounds. Laboratory testing is necessary to assess for conditions that can mimic Raynaud phenomenon or cause secondary Raynaud phenomenon. The selection of tests should be guided by the clinical findings. […] Nailfold capillaroscopy is the gold standard for differentiating primary Raynaud phenomenon from secondary Raynaud phenomenon (in particular, for identifying a scleroderma pattern). European guidelines note that capillaroscopy is not often performed in primary care, but recommend its use in secondary care, as abnormal capillary patterns are strong predictors of connective tissue disease. […] Magnetic resonance imaging has been studied in some forms of secondary Raynaud phenomenon. […] Smitaman and colleagues report that magnetic resonance imaging (MRI) scans of the feet of patients with Raynaud phenomenon demonstrate a progressive distal-to-proximal pattern of phalangeal bone marrow edema. They suggest that this finding may allow early diagnosis and treatment of rheumatologic disorders that may be associated with Raynaud phenomenon. […] Using cardiac MRI, Quarta et al demonstrated the presence of cold-induced cardiac ischemia in patients with systemic sclerosis and secondary Raynaud phenomenon, and showed that therapy with iloprost can reduce episodes of cardiac Raynaud phenomenon.

• #2 Raynaud’s phenomenon | NHS inform

  https://www.nhsinform.scot/illnesses-and-conditions/a-to-z/raynauds-phenomenon/

  Diagnosing Raynauds phenomenon can usually be diagnosed after an examination of your symptoms and some blood tests. […] Your GP may place your hands in cold water or cool air to see if you show symptoms of Raynauds. […] Further testing is usually recommended to find out whether you have primary or secondary Raynauds. […] Secondary Raynauds may require more treatment and, in some cases, referral to a specialist. […] Your GP may also check the tiny blood vessels, known as capillaries, found where your nail meets the finger. These capillaries are often larger in people with secondary Raynauds, and look like red pen marks.

• #2 Raynaud’s Syndrome | UCSF Department of Surgery

  https://surgery.ucsf.edu/condition/raynauds-syndrome

  Your doctor may ask about your risk factors for Raynaud’s. He or she also may ask about your signs and symptoms when you’re exposed to cold temperatures or stress. […] Your doctor will look at your fingers and toes to check the health of your skin and nails and to check blood flow to these areas. […] Your doctor may recommend the following tests to check for Raynaud’s and related conditions: […] A cold stimulation test can be used to trigger Raynaud’s symptoms. […] Your hands are then removed from the cold, and the device measures how quickly your fingers return to their normal temperature. […] If you have Raynaud’s, it may take more than 20 minutes for your fingers to return to their normal temperature. […] You may have a test called nailfold capillaroscopy. […] If your doctor sees abnormal arteries, it may mean you have a disease linked to Raynaud’s, such as scleroderma. […] Your doctor may order blood tests to look for conditions that are linked to secondary Raynaud’s.

• #2 Diagnosing Raynaud’s Phenomenon | Stanford Health Care

  https://stanfordhealthcare.org/medical-conditions/blood-heart-circulation/raynauds-phenomenon/diagnosis.html

  To diagnose Raynaud’s, your doctor will ask you questions about your symptoms and do a physical exam. You’ll need to describe what happens during an attack. If you can take a photo of the affected area during an attack, the photo may also be helpful to your doctor. […] There are no tests that can show that you have Raynaud’s. But your doctor may do a blood test or other tests to rule out diseases that may be causing your symptoms.

• #2 Raynaud’s Syndrome | Diagnosis & Disease Information

  https://www.rheumatologyadvisor.com/ddi/raynauds-syndrome/

  The workup may also include laboratory investigations, which should be tailored to the clinical findings. Examples of relevant studies include a complete blood count, comprehensive metabolic panel, rheumatoid factor, anti-cyclic citrullinated peptide, thyroid studies, hepatitis screening, anti-neutrophil cytoplasmic antibodies, and antiphospholipid antibodies. […] The minimal set of investigations should include nailfold capillary microscopy, complete blood count, erythrocyte sedimentation rate (ESR), and ANA.

• #2 Raynaud’s Syndrome: Symptoms, Causes, Diagnosis, Treatment, and Prevention

  https://www.everydayhealth.com/blood-disorders/raynauds-syndrome/

  They also rely on blood tests, according to Mayo Clinic, including: Antinuclear Antibodies (ANA) Test A positive result here indicates that your immune system is mistakenly attacking body tissue, triggering an autoimmune reaction. It suggests you might have connective tissue diseases or other autoimmune disorders. […] Erythrocyte Sedimentation Rate (ESR) This test measures the rate at which red blood cells fall to the bottom of a tube. A faster than typical rate might signal an inflammatory or autoimmune disease. […] These blood tests are often done to check if there are triggering factors or underlying systemic disease at play, Chawla says.

• #2 Raynaud Syndrome – Cardiovascular Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/cardiovascular-disorders/peripheral-arterial-disorders/raynaud-syndrome

  Findings suggesting secondary Raynaud syndrome are the following: Age at onset 30 years, Severe painful attacks that may be asymmetric and unilateral, Ischemic lesions, History and findings suggesting an accompanying disorder. […] Vascular laboratory testing includes measuring digital pulse wave forms and pressures. […] The main blood tests are to diagnose collagen vascular diseases (eg, measurement of erythrocyte sedimentation rate [ESR] or C-reactive protein, antinuclear and anti-DNA antibodies, rheumatoid factor, anticentromere antibody, anti-cyclic citrullinated peptide [CCP] antibodies, anti-scleroderma [SCL] 70 antibody). […] Diagnose clinically but consider testing to diagnose a suspected cause.

• #2 Raynaud’s Syndrome | Diagnosis & Disease Information

  https://www.rheumatologyadvisor.com/ddi/raynauds-syndrome/

  Referral to rheumatology for further evaluation is recommended to differentiate between primary and secondary Raynaud syndrome. Age may suggest primary or secondary etiology, as those with primary Raynaud syndrome typically develop symptoms between age 15 and 25. […] Features that should prompt consideration of secondary Raynaud syndrome include being male, first developing symptoms after age 30, signs of tissue ischemia, abnormal laboratory parameters that suggest another disease, and having unilateral symptoms. […] A rheumatologist typically performs the detailed diagnostic workup to differentiate primary and secondary Raynaud syndrome. This is due to the possible connective tissue disease etiologies of Raynaud syndrome. […] A nailfold capillary microscopy analysis of microvascular and morphologic changes in peripheral vessels is a non-invasive way to differentiate between primary and secondary Raynaud syndrome.

• #2 The pathogenesis, diagnosis and treatment of Raynaud phenomenon | Nature Reviews Rheumatology

  https://www.nature.com/articles/nrrheum.2012.96

  The past 10 years have seen the publication of results from several multicentre clinical trials in primary and systemic sclerosis (SSc)-related Raynaud phenomenon. […] The main advances in diagnosis have been a clearer understanding of autoantibodies and of abnormal nailfold capillary patterns as independent predictors of SSc, and widespread use and increased availability of capillaroscopy. […] In patients with Raynaud phenomenon, presence of SSc-specific autoantibodies and abnormal nailfold capillary pattern are independent predictors of an underlying SSc-spectrum disorder. […] New treatment approaches for Raynaud phenomenon include phosphodiesterase inhibitors and, for patients with SSc and recurrent digital ulcers, endothelin-1 receptor antagonists.

• #2 ¿Qué es el síndrome de Raynaud? Síntomas y tratamientos

  https://elgeaditraumatologia.com/en/enfermedad-raynaud-gravedad-causas-tratamiento/

  Raynaud’s syndrome is a condition characterized by episodes of spasm in the fingers of the hands and sometimes on the toes. […] Raynaud’s syndrome is a vascular condition in which a spasm occurs in the blood vessels in the fingers of the hands. and, on some occasions, the feet. This spasm decreases blood flow and causes a variety of skin changes, such as paleness, cyanosis, and redness, as well as a feeling of cold and numbness in the affected fingers. […] The exact cause of Raynaud’s syndrome is still unknown., it is known that there are several factors that can trigger episodes, such as cold, stress and some autoimmune diseases. […] To carry out the diagnosis of Raynaud’s syndrome, the doctor will perform a physical examination and may ask questions about symptoms and possible triggers. Additionally, your doctor may perform tests to rule out other medical conditions that may have similar symptoms, such as peripheral arterial disease or carpal tunnel syndrome.

• #2 Raynaud phenomenon | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/raynaud-phenomenon?lang=us

  Raynaud phenomenon is classified as being either 'primary’ or idiopathic, or 'secondary’ to another underlying condition (as discussed below). The diagnosis of Raynaud disease often refers to a primary Raynaud phenomenon. […] Although Raynaud phenomenon is primarily a clinical diagnosis, certain imaging modalities may be useful in supporting its diagnosis. […] DSA is considered the gold-standard imaging modality for visualization of extremity vessels in Raynaud phenomenon due to its high spatial and temporal resolution.

• #2

  https://link.springer.com/article/10.1007/s10067-019-04745-5

  Raynauds phenomenon (RP) is used to describe a symptom complex caused by digital vascular compromise. RP is a clinical diagnosis. The typically episodic nature of RP has resulted in a reliance upon patient self-report for diagnosis. […] The term secondary RP encompasses a broad range of rheumatological, haematological, endocrinological and vascular pathology. […] Recent work exploring the patient experience of SSc-RP is challenging the episodic paradigm of Raynauds, with important implications for clinical trials utilising diary-based patient-reported outcome instruments for assessing Raynauds symptoms. […] A practical approach to the evaluation and management of RP is outlined, highlighting important knowledge gaps and unmet research needs where applicable. […] Raynauds phenomenon is a symptom complex related to digital vascular compromise secondary to broad-ranging pathology. […] Raynauds phenomenon, as currently classified, likely encompasses a number of aetiopathogenic processes. […] Raynauds phenomenon causes significant disease-related morbidity in autoimmune rheumatic diseases such as systemic sclerosis.

• #2 ¿Qué es el síndrome de Raynaud? Síntomas y tratamientos

  https://elgeaditraumatologia.com/en/enfermedad-raynaud-gravedad-causas-tratamiento/

  Some tests that can be performed include: Blood test: to detect autoimmune disorders or hypothyroidism. […] Once the diagnosis of Raynaud’s syndrome has been confirmed, you can work with your doctor to develop an appropriate treatment plan. […] Raynaud’s syndrome is classified into two types: primary and secondary. […] Generally, secondary Raynaud syndrome requires more intensive monitoring and treatment due to underlying disease, while primary Raynaud syndrome is a milder condition with fewer complications. […] The symptoms you describe, such as swollen hands accompanied by a purple color and coldness, may be related to Raynaud’s disease, as this condition is characterized by a temporary reduction in blood flow to the extremities, especially in response to cold or stress. […] To determine if you truly have Raynaud’s disease, it’s important to have a complete evaluation by a specialized doctor.

Zobacz więcej