Raynaud’s phenomenon

Definition: Painful sequence of changes in fingers due to vasospasm (pallor), cyanosis and redness (hyperaemia). Can be primary or secondary.

Causes: Primary Raynaud’s (Raynaud’s disease) is idiopathic and typically affects young women. It is triggered by cold or emotional stimuli. There is often a family history of the condition.

Secondary Raynaud’s (Raynaud’s syndrome) affects older adults and is secondary to systemic connective tissues diseases (e.g. SLE) or occupational trauma due to operating vibrating machinery. Secondary Raynaud’s sequelae include ulceration and finger tip necrosis due to infarction.

 Examination: Raynaud’s disease (primary) is typically triggered by cold or emotional stimuli so there may be no obvious signs on physical examination. Taking a careful history which includes possible stimuli and description of digital colour changes is vital. Eliminating systemic disease (such as SLE) is also important. In SLE patients often present with Raynaud’s phenomenum and arthritis/arthralgia.