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Raynauds phenomenonFrom the lecture by Prof. Duprez, cardiologist UZ Gent, on 13 June 1998- province of Oost-Vlaanderen
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| What is Raynauds phenomenon? |
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Raynauds phenomenon is a condition characterised by cold-induced spasms in the small arteries of the fingers. Fingers and toes are the body parts most affected, which first turn white and then blue due to a reduced blood circulation. Raynauds phenomenon is often present before there are other symptoms of connective tissue diseases.
There is a difference between the primary and secondary phenomenon. |
| The diagnosis of the Raynaud's phenomenon |
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A simulation can be carried out in a Raynaud test by measuring the blood circulation in the fingers. Pieces of mercury strings are attached to the fingers and small cuffs are placed a bit higher. These small cuffs are inflated with a pressure of 50 mm mercury for 3 heartbeats, after which they are ventilated. This means that the arterial blood flows through while the venous blood does not. The fingers dilate microscopically and a small electrical current flows through in order to measure the resistance of the flow in the fingers. In practice, the blood flow in the fingers is good at 40C, but at a temperature of 20, 10 or 5C, the blood vessels contract and the circulation decreases after which the temperature is forced up again. In primary Raynaud's phenomenon there is a significant increase of blood circulation in the fingers at a temperature of 40C, while in secondary Raynauds phenomenon, a slow recovery is observed.
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| The difference between primary and secondary Raynaud's phenomenon |
| The primary Raynaud's phenomenon is based on an increased activity of the nervous system, while the secondary type, as a part of a connective tissue pathology, has to do with the change of structure of the blood vessels.
Years before the patient complains about other symptoms, the Raynaud's phenomenon can be an indication of a developing connective tissue pathology. By performing this painless and harmless test, the primary Raynaud's phenomenon can be easily distinguished from the secondary type.
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| Capillaroscopy |
| In connective tissue diseases it is sometimes necessary to perform a tissue biopsy to be able to justify the diagnosis. A new technique, called the capillaroscopy, has made it possible to examine the capillaries without removing pieces of tissue. On the cuticle of the fourth finger, oil immersion is applied and by means of the microscope not only the shape of the capillaries can be seen, but also the speed of the blood circulation.
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