Raynaud’s Phenomenon

Abstract

Raynaud's phenomenon (RP) is a clinical consequence of recurrent vasospasm of the small arteries and arterioles of the fingers and toes provoked by cold and emotional stress. RP is classified into two categories, i.e., primary and secondary RP. Primary RP is an isolated finding in the absence of an underlying pathology, while secondary RP is a syndrome in the context of another disease. The patients with primary RP have a younger age at onset, sparing of the thumb, and benign course without development of digital ulcers. Contrarily, secondary RP is characterized with later age of onset above 30 years, thumb involvement, and more severe course with possible development of trophic changes. In these cases, a focused, complaint-directed history and physical examination aim to reveal clinical symptoms and findings that confirm the presence of an underlying disorder, e.g., connective tissue disease (CTD) or other pathology. Together with clinical examination, laboratory, immunological, and capillaroscopic assessments facilitate the internal differential diagnosis of secondary RP. The capillaroscopic examination should be performed in all patients with symptoms of RP even in those cases without signs of systemic rheumatic disease, because the abnormal capillaroscopic picture inherits a high positive predictive value for the development of CTD.

A Multiscale Approach for Predicting Certain Effects of Hand-Transmitted Vibration on Finger Arteries

“…Such vibrations are liable to cause angioneuronal disorders. In particular, they can lead to the development of vibration-induced Raynaud's syndrome [14,15], i.e., Vibration White Finger (VWF) [16]. In French companies, more than three-quarters of employees exposed to hand-arm vibrations use handheld or hand-guided machines [2], generating vibrations of frequencies higher than 50 Hz.…”

“…The physiopathology of vibration-induced Raynaud's syndrome is very complex, highly multifactorial, and still remains poorly understood [15,16,[27][28][29][30]. In a highly schematic and simplified way, we have modeled the development of Raynaud's vibration syndrome in several stages, from which emerge two steps in time and space (Figure 1).…”