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Condition/Disorder Synonyms

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  • Raynaud phenomenon

  • Raynauds

  • Primary Raynauds

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ICD-9-CM Codes

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  • 443.0 Raynaud's syndrome

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ICD-10-CM Codes

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  • I73.00 Raynaud's syndrome without gangrene

  • I73.01 Raynaud's syndrome with gangrene

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Preferred Practice Pattern

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Key Features

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Description

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  • Vasospasm of the arteries to the distal extremities.

  • Most common in the fingers and toes, can affect the nose, ears and lips

  • Sensitivity to cold

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Essentials of Diagnosis

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  • Primary Raynauds the etiology is unknown, more common

    • - Criteria for primary Raynaud Phenomenon (See table)2

  • Secondary Raynauds has a known etiology from another disease or cause

    • - Criteria for secondary Raynaud Phenomenon (See table)3

      • Connective tissue disease

      • Obstructive arterial disease

      • Neurologic disorders

      • Drugs and toxins

      • Occupational/environmental exposure

      • Hyperviscosity

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General Considerations

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  • Cold temperature can cause a Raynaud attack where there is a brief period of little to no blood flow.

  • Brief temperature changes can cause an attack

  • Can cause skin sores or gangrene

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Demographics

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  • Affects 10% of the population4

  • Primary Raynauds usually begins before age 30

  • Secondary Raynauds usually begins after age 30

  • Women are more likely then men, 4:1 ratio4

  • Family history

  • Living in cold regions

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Clinical Findings

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Signs and Symptoms

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  • Throbbing

  • Tingling

  • Burning

  • Decreased sensation

  • Circulation changes: white or redness

  • Rare occasions: skin sore and gangrene

  • Dry skin

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Functional Implications

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  • Severe symptoms may cause inability to leave home in the winter

  • Limit fine finger dexterity

  • Limited ROM, ADLs, IADLs

  • Lifestyle changes secondary to pain and fatigue

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Possible Contributing Causes

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  • Physical or emotional stress, anxiety

  • Systemic immunological condition (inflammatory autoimmune disease)

  • Medication side effects that cuse constriction

  • Toxin or chemical exposure

  • Diseases that damage arteries or the nerves that control the arteries

  • Rheumatoid arthritis

  • Atherosclerosis

  • Cryoglobulinemia

  • Sjogren's syndrome

  • Thyroid problems

  • Work hazards like excessive vibration

  • Frostbite

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Differential Diagnosis

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  • Carpal tunnel syndrome

  • Thoracic outlet syndrome

  • Chronic fatigue syndrome

  • Sjogren's syndrome

  • Vasculitis

  • Rheumatoid arthritis

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Means of Confirmation or Diagnosis

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Laboratory Tests

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  • Blood tests, complete blood count (CBC)

  • Chemistry panel (kidney function, liver, electrolytes, blood sugar, cholesterol, triglycerides)

    • - Erythrocyte sedimentation rate (ESR)

    • - Antinuclear antibody (ANA)

    • - C-reactive protein (CRP)

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Imaging

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  • MRI

  • Doppler Ultrasound

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Diagnostic Procedures

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  • Cold stimulation test

  • Nailford Capillaroscopy

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Findings and Interpretation

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  • Decreased blood flow with cold temperature

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