Raynauds Phenomenon
Links
Services- Rheumatology
Raynauds Phenomenon- Surgery
Definition
Typical colour changes of white, red and blue in usually hands
but may occur in the feet. Primary Raynaud's accounts for 90% of
cases but a secondary cause should be sought.
When to refer
- to identify a secondary cause e.g.
- Systemic lupus erythematosis
- rheumatoid arthritis
- scleroderma/CREST syndrome
- Sjogrens syndrome
- When first line management is not effective.
- When there is pulp and nail fold changes in fingers or feet.
- Persistence of symptoms through summer and winter.
- To evaluate vibration white finger (a notifiable occupational
disease).
Investigations
- FBC
- ESR/PV
- Profile
- Autoantibodies including Rheumatoid factor
- Rheumatology referral
First Line Management
- Ensure core body temperature is well maintained this often
necessitates wearing thermal underwear.
- Wear prewarmed gloves and put them on BEFORE entering a change
of temperature.
- Vasodilators: try Thymoxamine (opilon) upto 80mg tds or nifedipine
20mg upto tds. Advice to start 2 days before weather forecast
advises a cold snap and continue for about 2 weeks.
Special Points
The Raynauds and Scleroderma assciation support group offer helpful
advice.
Document Information
Expiry Date: 11/04/04
Author: Kennedy Tom Dr
Organisation: Arrowe Park Hospital
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