Raynaud's phenomenon is the term used to describes episodic vasospasm of the digital vasculature in response to cold exposure and/or emotional distress. The majority of people with Raynaud's phenomenon have primary (idiopathic) Raynaud's phenomenon which is 'benign' in that it does not progress to irreversible digital ischaemia, and is not associated with any underlying disease. Conversely, when Raynaud's phenomenon is secondary to an underlying disease/condition (for example to a systemic sclerosis-spectrum disorder), it can be severe, sometimes progressing to digital ulceration and/or gangrene. Raynaud's phenomenon is often the presenting feature of connective tissue disease and therefore provides a window of opportunity for early diagnosis.
The first step in management of Raynaud's phenemenon is establishing the diagnosis. Is this primary or secondary Raynaud's, and if secondary, then to what? While a careful history and examination are always the first steps, different laboratory tests and vascular imaging studies can be used to reach the correct diagnosis. This presentation will provide practicing rheumatologists with a practical approach to the diagnosis and assessment of Raynaud's phenomenon, focussing on the diagnostic and prognostic role of vascular imaging (including nailfold capillaroscopy and thermography).
Disclosure of Interest None declared