Rheumatology: Raynaud's

Question 1

What is Raynaud’s?

Answer 1

Condition due to vasospasm of the digits. It is painful and is characterized by a typical sequence of colour changes in response to a cold stimulus. It is often also precipitated by stress.

white - inadequate blood flow
blue - venous stasis
red - re-warming hyperaemia

Raynaud’s syndrome = when Raynaud’s phenomenon is idiopathic

Question 2

What diseases are associated with Raynaud’s phenomenon (RP)?

Answer 2

RP is associated with:

• scleroderma
• SLE
• dermatomyositis and polymyositis
• Sjogren’s syndrome

Physical causes:

• use of heavy vibrating tools
• cervical rib
• “sticky” blood e.g. cryoglobulinemia

Drug induced: beta blockers

Question 3

How should Raynaud’s be managed?

Answer 3

Keep warm and to avoid smoking

Ca-channel blockers are the first-line - amlodipine

Phosphodiesterase-5 inhibitors, and prostacyclins are usually effective

Question 4

What are the complications of Raynaud’s?

Answer 4

Digital ulcers

Severe digital ischaemia

Infection