Scleroderma Types Systemic Symptoms Raynaud's

Diagnosis of Raynaud's

Overview of Raynaud's Diagnosis

Do your fingers or toes ever turn white?

Raynaud's is diagnosed simply by asking the patient if their fingers or toes ever turn white.

There are no blood tests to diagnose it, although the majority of patients who have an associated autoimmune disease will also have autoantibodies or other evidence of inflammation in their blood. (Also see What is Raynaud's?, What is Scleroderma?, Types of Scleroderma, and Systemic Sclerosis)

Primary Raynaud's

Primary Raynaud's = Raynaud's by itself, with no other illness causing it.
This is also known as Raynaud's Disease.

Primary Raynaud's. When Raynaud's appears by itself, without any other medical condition, it is called Primary Raynaud's, or Raynaud's Disease. More than 80% of people with Raynaud's have it by itself, not caused by any serious underlying illness. ISN.

Seconday Raynaud's

Secondary Raynaud's = Raynaud's due to another illness.
This is also known as Raynaud's Phenomenon.

Secondary Raynaud's. When Raynaud's appears along with autoimmune diseases such as scleroderma, systemic lupus erythematosus, or rheumatoid arthritis, it is called Secondary Raynaud's, or Raynaud's Phenomenon. ISN.

Nailfold Capillaroscopy

Nailfold Capillaroscopy is the best way to tell if someone has primary or seconday Raynaud's. Capillaries are very tiny blood vessels. Capillaries are very close to the surface of the skin, particularly near the base of fingernails. ISN.

Nailfold Capillaroscopy is used by some doctors. A drop of oil is put on the nailfolds and then looked at under a magnifying glass to see whether there are changes in the capillaries which are indicative of connective tissue disease.

Cold Stimulation Test

Perfusion Scintigraphy for the Evaluation of Patients with Raynaud's Phenomenon (RP). Perfusion scintigraphy, with or without cold stimulation, can be used to evaluate RP. PubMed, Nucl Med Mol Imaging, 2020 Dec;54(6):269-273.

Do not let your doctor dunk your hands in ice water to test for Raynaud's! It is painful, unnecessary and possibly even dangerous!

Some doctors run a Cold Stimulation Test which involves taping a heat sensor to your hand, then submerging them in an ice-water bath to measure how long it takes to return to normal temperature. Needless to say, this test is not very popular with Raynaud's patients as it is both painful and unnecessary. It is also hazardous if you have gangrene or open, infected wounds on your hands. No tests are required to diagnose Raynaud's!

No Tests Required to Make Diagnosis

No tests are required to make the diagnosis of Raynaud's. Laboratory, radiological, or Doppler tests are best used to assess the severity of the disease and as a guide for treatment.

Magnetic Resonance Angiography (MRA)

Combining optical coherence tomography with magnetic resonance angiography and Doppler ultrasonography for clinical detection of scleroderma (SD). Multimodal imaging techniques offer a more comprehensive characterization of the morphological and functional information of biological tissues, which can assist physicians to achieve a more accurate SD diagnosis. PubMed, Anat Rec (Hoboken), 2020 Dec;303(12):3108-3116.

Vascular Laboratory Testing

Many different tests may be run in a vascular lab to assess the severity of Raynaud's. They may measure blood pressure in each finger, test your response to cooling and rewarming, and use heated Doppler's.

Freezing Fingers Syndrome, Primary and Secondary Raynaud's Phenomenon (RP): Characteristic Features with Hand Thermography. RP should be suspected when differences between mean temperatures of the metacarpus and digits are =to 3ºC. PubMed, Acta Derm Venereol.

References

(1) Dr. Maureen Mayes.

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