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Features suggesting secondary to connective tissue disorder

Authoring team

These include:

  • development of Raynaud's phenomenon (RP) at an older age (i.e. > 30 years old), and particularly in males, suggests the possibility that RP is secondary to some underlying connective tissue disease (CTD), and this should prompt investigation for an underlying cause

  • RP occurs in more than 90% of patients with systemic sclerosis and in up to 40% of cases with systemic lupus erythematosus and idiopathic inflammatory myositis

  • other additional features that makes a secondary cause of RP more likely include:

  • digital ulceration, or year-round symptoms
  • abnormal nail fold capillaries (viewed with an ophthalmoscope with the +20 lens)
  • asymmetric upper limb pulses or bruits
  • puffiness/tightness of the finger skin
  • elevated ESR
  • positive ANA or other antibodies (Ro/La/Scl-70 etc)

Reference:

  • 1) Arthritis Research Campaign (2000). Rheumatic Disease In Practice, September 2000, 3.

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