Raynaud's phenomenon

Question 1

What is Raynaud’s phenomenon?

Answer 1

Condition due to vasospasm of the digits. Painful and characterised by a typical sequence of colour changes in response to a cold stimulus. Often precipitated by stress

Question 2

What do the 3 different colour changes mean in Raynaud’s?

Answer 2

White - inadequate blood flow
Blue - venous stasis
Red - rewarming hyperaemia

Question 3

What is Raynaud’s syndrome?

Answer 3

When Raynaud’s phenomenon is idiopathic.
Common in young women and may improve as they get older
May be familial

Question 4

What diseases are associated with Raynaud’s phenomenon?

Answer 4

• Scleroderma
• SLE
• Dermatomyositis and polymyositis
• Sjogren’s syndrome

Rheumatic cause indicated by abnormal nail fold capillaries or puffy fingers or photosensitive rash

If RP develops in a patient over 30 years suggests underlying disease

Question 5

What are physical causes of Raynaud’s phenomenon?

What can cause drug induced RP?

Answer 5

• Use of heavy vibrating tools
• Sticky blood - cryoglobulinaemia
• Cervical rib

Beta blockers

Question 6

What is the treatment for RP?

Answer 6

• Advise patients to keep warm and avoid smoking
• CCB 1st line
• PDE-5 inhibitors and prostacyclins also work well

Question 7

What are complications of RP?

Answer 7

• Digital ulcers
• Severe digital ischaemia
• Infection (of digits)

Question 8

What is nail-fold capillaroscopy?

Answer 8

A non-invasive technique used to diagnosis scleroderma and DM - allows for evaluation of characteristic structural changes in peripheral microcirculation