Review of Different Quantification Methods for the Diagnosis of Digital Vascular Abnormalities in Hand‐arm Vibration Syndrome

Abstract

This study was undertaken to review the diagnostic ability of different quantification methods in the assessment of vibration-induced white finger (VWF), the typical clinical manifestation of vascular injuries in Hand-arm Vibration Syndrome (HAVS). Methods: A literature search of original and major review articles related to the quantification techniques for diagnosing vascular injuries in HAVS was performed. Relevant data from the publications were extracted and included in this study for reporting and discussion. Results: Few studies were available to substantiate the diagnostic techniques using the nail press test and nailfold capillaroscopy. Also, few studies were found to conclusively demonstrate the diagnostic ability using thermometry and thermography incorporated with cold provocation. Some recent reports raised the question regarding the diagnostic ability of finger plethysmography; but by virtue of its comparable assessment parameters and better diagnostic performance, plethysmography appears to be a suitable diagnostic method. In noninvasive quantification of vascular injuries, diagnostic techniques like laser Doppler perfusion imaging and nailfold capillaroscopy require further evaluation in future studies. Conclusions: For a reliable objective diagnosis of VWF at present, quantification of vascular responses using a test battery including established methods like thermometry or thermography and strain gauge plethysmography appears to be useful. (J Occup Health 2011; 53: 241-249)

Nailfold capillary microscopy for evaluating hand-arm vibration syndrome

“…These tests are used to evaluate skin microcirculation and morphology of capillary. Among these tests, nailfold capillary microscopy is considered one of the established methods to diagnose and monitor collagen-vascular diseases because it can evaluate structural changes in the superficial cutaneous vasculature [4,5].…”

“…The reproducibility of this diagnostic method is also unknown, thus it is not preferred [4]. Furthermore, thermometry and thermography tends to exhibit inconsistent sensitivity and specificity depending on the study [4].…”

“…The reproducibility of this diagnostic method is also unknown, thus it is not preferred [4]. Furthermore, thermometry and thermography tends to exhibit inconsistent sensitivity and specificity depending on the study [4]. In addition, a limitation of laser Doppler flowmetry is that it has low reproducibility in microcirculation studies based on physiological changes [4].…”

“…Furthermore, thermometry and thermography tends to exhibit inconsistent sensitivity and specificity depending on the study [4]. In addition, a limitation of laser Doppler flowmetry is that it has low reproducibility in microcirculation studies based on physiological changes [4]. Plethysmography is expensive, complicated, and requires a skilled examiner to ensure the accuracy of the test results [4].…”

“…In addition, a limitation of laser Doppler flowmetry is that it has low reproducibility in microcirculation studies based on physiological changes [4]. Plethysmography is expensive, complicated, and requires a skilled examiner to ensure the accuracy of the test results [4]. Owing to the problems posed by the aforementioned diagnostic methods, cold provocation test and finger angiography are commonly used.…”