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Investigations

Authoring team

Routine blood tests are not carried out in primary Raynaud’s phenomenon (1).

A small group of investigations are helpful in patients with a clinical suspicion of secondary Raynaud’s phenomenon:

  • full blood count and ESR
  • presence of anaemia and lymphopenia, may suggest an underlying autoimmune disease;
  • immunology test for antinuclear antibodies (ANA), anti-Ro (SS-A), and anti-La (SS-B) etc
  • examination of nailfold capillaries:
  • capillaroscopy is better since ophthalmoscopy (20× magnification, dermatoscope 10× magnification) can miss capillary changes
  • but the gold standard method is videocapillaroscopy (200× magnification, or a biomicroscope)
  • shows abnormal morphological patterns, e.g. dilatation, haemorrhages, loss of capillaries, angiogenesis etc (1)
  • chest X-ray - in patients with unilateral signs to look for a cervical rib compressing the bronchial and cephalic vascular branches
  • renal and liver function tests
  • TFTs
  • cryoglobulin estimation
  • urinalysis
  • hand X-ray (1,2,3)

Specialist investigations carried out in secondary care include:

  • infrared thermography
  • laser doppler flowmetry
  • portable radiometry
  • digital plethymography (1)

Note:

  • laboratory tests must be used in conjunction with clinical features (1).

Reference:


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