RAYNAUD DISEASE ?/RAYNAUD PHENOMENON?/DIFFERENCE BETWEEN PRIMARY AND SECONDARY RAYNAUD DISEASE

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                  RAYNAUD DISEASE 

INTRODUCTION:

Raynaud phenomenon: 

  • Vascular disease characterized by intermittent arteriolar vasospasm of the digits
  • Etiology :Cold temperature /stress
  • Features: Exaggerated vasoconstriction of digital arteries and arterioles
  • Pain
  • Pallor
  • Cyanosis
  • Hyperemia
  • Symptoms present with characteristic changing of hands from white to blue to red







PRIMARY RAYNAUD PHENOMENON:

  • Also known as RAYMAUD DISEASE
  • Less severe than secondary 
  • Its seen in females
  • Usually bilateral
  • Occur :upper limb and normal peripheral pulses
  • Etiology :abnormal sensitivity to cold that result in upper limb (hand ) arteriolar spasm
  • Symptoms can be precipitated
  • Observed by placing hands in cold water









DIFFERENCE BETWEEN RAYNAUD PHENOMENON AND SECONDARY RAYNAUD PHENOMENON

PRIMARY RAYNAUD PHENOMENON:

  • Also known as Raynaud disease
  • Less severe than secondary 
  • Vasospasm is not associated with ischemic injury or an underlying associated disease
  • Sex:women
  • Age: <30 years
  • Involves all fingers symmetrically excluding thumbs 
  • No structural abnormality in the arterial wall (later in course thickening of intima present)
  • No history of peripheral vascular disease or ischemic injury
  • Anti nuclear antibody titre -normal or low (on indirect immunofluorescence)
  • Nailfold capillaries normal 

SECONDARY RAYNAUD PHENOMENON:

  • Also known as Raynaud syndrome
  • Very severe
  • Associated with underlying disease (systemic sclerosis)
  • Associated with vasospasm and concurrent ischemia 
  • Painful attack
  • Asymmetric involvement of digits
  • Torturous nail fold
  • Digital necrosis












INVESTIGATION:

  • Type is identified by angiogram of palm
  • X-ray of the part of limb affected

TREATMENT :

  • Treat the cause 
  • Avoid precipitating factor
  • Small dose of aspirin (100 mg daily)








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