Diagnostic Tests for Raynaud's phenomenon


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Diagnostic Test list for Raynaud's phenomenon: The list of diagnostic tests mentioned in various sources as used in the diagnosis of Raynaud's phenomenon includes:

Tests and diagnosis discussion for Raynaud's phenomenon: If a doctor suspects Raynaud's phenomenon, he or she will ask the patient for a detailed medical history. The doctor will then examine the patient to rule out other medical problems. The patient might have a vasospastic attack during the office visit, which makes it easier for the doctor to diagnose Raynaud's phenomenon. Most doctors find it fairly easy to diagnose Raynaud's phenomenon but more difficult to identify the form of the disorder. (See the box for the criteria doctors use to diagnose primary or secondary Raynaud's phenomenon.)

Nailfold capillaroscopy (study of capillaries under a microscope) can help the doctor distinguish between primary and secondary Raynaud's phenomenon. During this test, the doctor puts a drop of oil on the patient's nailfolds, the skin at the base of the fingernail. The doctor then examines the nailfolds under a microscope to look for abnormalities of the tiny blood vessels called capillaries. If the capillaries are enlarged or deformed, the patient may have a connective tissue disease.

The doctor may also order two particular blood tests, an antinuclear antibody test (ANA) and an erythrocyte sedimentation rate (ESR). The ANA test determines whether the body is producing special proteins (antibodies) often found in people who have connective tissue diseases or other autoimmune disorders. The ESR test is a measure of inflammation in the body and tests how fast red blood cells settle out of unclotted blood. Inflammation in the body causes an elevated ESR.

Diagnostic Criteria for Raynaud's Phenomenon

Primary Raynaud's Phenomenon

  • Periodic vasospastic attacks of pallor or cyanosis (some doctors include the additional criterion of the presence of these attacks for at least 2 years)

  • Normal nailfold capillary pattern

  • Negative antinuclear antibody test

  • Normal erythrocyte sedimentation rate

  • Absence of pitting scars or ulcers of the skin, or gangrene (tissue death) in the fingers or toes

Secondary Raynaud's Phenomenon

  • Periodic vasospastic attacks of pallor and cyanosis

  • Abnormal nailfold capillary pattern

  • Positive antinuclear antibody test

  • Abnormal erythrocyte sedimentation rate

  • Presence of pitting scars or ulcers of the skin, or gangrene in the fingers or toes
1

An attack is usually temporary, so the doctor relies on the patient's description to diagnose the problem. The doctor will also determine whether the patient has Raynaud's alone (called primary Raynaud's phenomenon) or if another disease or some aspect of the patient's lifestyle is causing the symptoms. If the problem is caused by another disease or risk factor, the patient is said to have secondary Raynaud's phenomenon. 2

Footnotes:
1. excerpt from Questions and Answers about Raynaud's Phenomenon: NIAMS
2. excerpt from NHLBI, Raynaud's Phenomenon: NHLBI

Last revision: June 12, 2003

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