Raynaud Syndrome

Diagnosis: Raynaud Syndrome

Raynaud Syndrome

Clinical Presentation

Raynaud Syndrome

Clinical History

Submitted by Ellie Goulding MD. Originally posted January 23, 2017.

Treatment

See case discussion.

Differential Diagnosis

• Peripheral arterial disease • Acrocyanosis • Chilblains (pernio) • Thoracic outlet syndrome • Complex regional pain syndrome • Buerger disease • Cryoglobulinemia

Key Learnings

• Episodic vasospasm of digital arteries — classic triphasic color change: white → blue → red • Primary Raynaud (Raynaud disease): benign, bilateral, symmetric, no tissue damage — young women • Secondary Raynaud (Raynaud phenomenon): associated with underlying CTD — especially systemic sclerosis • Nailfold capillaroscopy is key to differentiating primary from secondary • Red flags for secondary: asymmetric attacks, digital ulcers/gangrene, onset after 30, abnormal nailfold capillaries, positive ANA/anti-Scl-70 • Cold avoidance and vasodilators are cornerstone of treatment

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