Diagnosis of Primary Raynaud's using Nailfold Capillaroscopy

Author: Shelley Ensz. Scleroderma is highly variable. See Types of Scleroderma. Read Disclaimer
Nailfold Cap. for Primary Raynaud's
Nailfold Capillaroscopy vs. Doppler
HRQOL with Primary Raynauds
Seconday Raynaud's


Primary Raynaud's = Raynaud's by itself, with no other illness causing it. This is also known as Raynaud's Disease.

When Raynaud's appears by itself, without any other medical condition, it is called Primary Raynaud's, or Raynaud's Disease. The majority of people with Raynaud's have it by itself, not caused by any serious underlying illness.

Raynaud's is diagnosed simply by asking the patient if their fingers or toes ever turn white. There are no other tests necessary to diagnose Raynaud's.

Therefore, the purpose of testing is to determine whether people with Raynaud's already have, or are at risk for developing, a connective tissue disease such as scleroderma, dermatomyositis, or lupus. People who are at risk usually, but not always, have detectable antibodies or other markers of inflammation in their blood or skin biopsies.

Nailfold Capillaroscopy for Primary Raynaud's

If capillaroscopy equipment is not available, a handheld dermatoscope works equally well for detecting nailfold abnormalities.

Nailfold capillarscopy can quickly and painlessly determine the difference between primary and secondary Raynaud's. Thus it can also enable speedier diagnosis of connective tissue diseases plus provide necessary peace of mind for those who have normal results.

Despite the ease, noninvasiveness, and accuracy of nailfold capillaroscopy, it is seldom done in the U.S. because it the procedure is usually not sufficiently covered by health insurance policies.

Capillaroscopy (Includes Photos). Capillaroscopy is the most reliable way to distinguish between primary and secondary Raynaud's phenomenon through identification of an early pattern of systemic sclerosis. (PubMed) M. Cutolo. Best Pract Res Clin Rheumatol.

Raynaud Phenomenon. Raynaud phenomenon manifests as recurrent vasospasm of the fingers and toes and usually occurs in response to stress or cold exposure. Secondary Raynaud phenomenon should be distinguished from primary Raynaud phenomenon (Raynaud disease). A Anita Narayanan, MD. emedicine from WebMD.

Nailfold capillaroscopic findings in primary Sjögren's syndrome with and without Raynaud's phenomenon and/or positive anti-SSA/Ro and anti-SSB/La antibodies. Patients with RP associated with PSS had more dilated capillaries, but neither pericapillary haemorrhages nor capillary thrombosis was observed. PubMed, Rheumatol Int. (Also see Diagnosis of Sjogren's Syndrome)

(Case Report) The role of capillaroscopy in differentiation of primary and secondary Raynaud's phenomenon in rheumatic diseases. In conclusion, capillaroscopy is of crucial importance for the differentiation of primary and secondary RP in rheumatic diseases, and also in differentiation between different forms of connective tissue diseases as well as for their early diagnosis. Sevdalina Nikolova Lambova. (SpringerLink) Rheumatology International.

Nailfold Capillaroscopy vs. Doppler Imaging

Doppler imaging can also be used effectively to differentiate primary from secondary Raynaud's.

Comparison of laser Doppler imaging (LDI), fingertip lacticemy test (FTL), and nailfold capillaroscopy (NFC) for assessment of digital microcirculation in systemic sclerosis (SSc). LDI showed lower digital blood flow in SSc patients when compared with healthy controls and correlated well with FTL both at baseline and after cold stimulus, allowing objective measurement of blood perfusion in SSc patients. MJ Correa. (PubMed) Arthritis Res Ther.

Health-Related Quality of Life (HRQL) in Primary Raynaud's

People with primary Raynaud's report a lower quality of life than entirely healthy people.They also seem to suffer from more anxiety and depression. Patient education and support might alleviate some concerns. (Also see What is Raynaud's?)

Sclero Forums, Chats and Blogs provides free, online, well-moderated support for scleroderma and related illnesses (such as Raynaud's). ISN.

Scleroderma Skin Involvement: Fingernail, Nailfolds, and Cuticles

Scleroderma Skin Involvement: Fingernail, Nailfolds, and Cuticles. The systemic forms of scleroderma can cause the fingernails to become smaller, and cuticles to become hard or rough. But because there are so many possible causes of poor fingernail or cuticle condition, they are not part of the diagnostic criteria for any form of scleroderma. ISN.

Cuticles: Periungual Erythema
Fingernail Abnormalities
Causes of Fingernail Symptoms and Abnormalities
Lack of Fingerprints
Manicure Safety
Nail Biting
Nailfold Capillaroscopy

Nailfold Capillaroscopy for Secondary Raynaud's

Nailfold Capillaroscopy for Secondary Raynaud's. When Raynaud's appears by itself, without any other medical condition, it is called Primary Raynaud's, or Raynaud's Disease. ISN.

Diagnosis of Primary vs Secondary
Raynaud's Secondary to Scleroderma
Raynaud's Secondary to Other Diseases
Go to Raynaud's Treatments

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