| Popis: |
Of 405 patients with Raynaud's phenomenon seen for clinical investigation, including 210 with vibration-induced white fingers, 365 were evaluated with sequential determination of digital temperature recovery time after cold exposure, and plethysmography after cold provocation. The results of this objective testing were compared with the results of the clinical evaluation in an attempt to check the former's usefulness as a tool to prove the diagnosis of the vasospastic condition and to assess its degree of impairment. The sensitivity of digital recovery time and plethysmography was, respectively, 56.5% and 80.5% in the primary Raynaud's phenomenon, 48.7% and 67.8% in the secondary Raynaud's phenomenon, and 49.1% and 69.7% in the vibration syndromes. The specificity of these tests was 79.6% and 67.7% for the secondary Raynaud's phenomenon, and 71.4% and 36.8% for the vibration syndrome. When digital recovery time and plethysmography are used together, the sensitivity is increased to 78.8% for the vibration-induced white fingers and 85.5% for the primary Raynaud's phenomenon. Objective evidence of Raynaud's phenomenon can be obtained by provocative digital recovery time and plethysmography, especially if the two tests are considered together, but their response was too unpredictable to assess accurately the degree of severity and the degree of impairment caused by the vasospastic disease. Nevertheless, they remain a useful and necessary adjunct to the clinical evaluation, particularly when dealing with occupational Raynaud's phenomenon. |
