RAYNAUD'S PHENOM...

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Raynaud's phenomenon

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Definition

Raynaud’s phenomenon is a condition in which cold temperatures or strong emotions cause blood vessel spasms that block blood flow to the fingers, toes, ears, and nose.

Causes, incidence, and risk factors

Raynaud's phenomenon can be associated with other conditions. This is called secondary Reynaud's phenomenon. Most people with the condition are over age 30.

Common causes are:

• Diseases of the arteries, such as atherosclerosis and buerger's disease
• Drugs that cause narrowing of arteries, such as amphetamines, certain types of beta-blockers, some cancer drugs, ergot compounds, and methysergide
• Arthritis and autoimmune conditions, such as scleroderma, Sjogren syndrome, rheumatoid arthritis, and systemic lupus erythematosus
• Repeated injury, particularly from vibrations such as those caused by typing or playing the piano
• Smoking
• Frostbite
• Thoracic outlet syndrome

Raynaud's phenomenon also occurs without another disease, medication, or cause. This is called primary Raynaud's phenomenon. It is most often seen in people younger than age 30.

Symptoms

Strong emotions or exposure to the cold causes the fingers, toes, ears, or nose to become white, then turn blue. When blood flow returns, the area becomes red and then later returns to normal color. The attacks may last from minutes to hours.

People with primary Raynaud's phenomenon (no other cause or condition) have problems in the same fingers on both sides, but they do not have very much pain.

People with secondary Raynaud's phenomenon (associated with other medical conditions) are more likely to have pain in different fingers. They often have pain and tingling.

Signs and tests

The doctor will perform a physical exam. Vascular ultrasound and a cold stimulation test for Raynaud's phenomenon may be done.

Different blood tests may be done to diagnose arthritic and autoimmune conditions that may cause Raynaud's phenomenon.

Reviewer Info: Mark James Borigini, Associate Clinical Professor of Medicine, University of California, Irvine, Irvine, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc., 05/31/2009