Raynaud’s Phenomenon
This page is provided by Thomas J. A. Lehman MD
Delivering the
best care - with great care
Dr. Lehman is the author
of many textbook chapters and articles on the care of children and young adults
with Raynaud’s and associated rheumatic diseases. He practices in
All information is provided as a public service and no warranty is expressed or implied.
If you would like a more detailed discussion click here for information
regarding a book I have written.
Raynaud’s is described as Raynaud’s disease, Raynaud’s
phenomenon, or Raynaud’s syndrome. Although some people carelessly use these
terms interchangeably, these aren’t all the same thing. What’s going on? It helps to know a little history. Raynaud was a French medical student in the
late 1800’s who had to write a thesis as one of the requirements for
graduation. He decided to write about
the color changes he saw in the hands of women waiting for the streetcar on
cold winter days. In true Raynaud’s a
persons fingers will blanch white when they are very cold and there is little
or no blood circulating to the fingers.
As the hands warm up the blood flow returns and the fingers turn
red. After this they go back to their
normal condition which is usually bluish and cold with poor circulation. Unless the fingers turn all three colors it
is not Raynaud’s. This same sequence of
color changes can be provoked by emotion in some people (like flushing when you
are embarrassed). It may also occur in
the toes and infrequently in the ears and nose, etc. when they become cold.
Raynaud’s
phenomenon describes the color changes.
When they occur without any other problem it is called Raynaud’s
disease. However if the color changes
occur in someone who has another rheumatic disease then it is called Raynaud’s
syndrome. Raynaud’s disease is a minor
inconvenience, which is not terribly important.
Raynaud’s syndrome is significant because of whatever disease it is
associated with.
Many
people come to medical attention because of Raynaud’s and it is not initially
clear whether they have an underlying rheumatic disease or simply Raynaud’s
disease. Almost any rheumatic disease
can be associated with Raynaud’s.
Rheumatoid arthritis, scleroderma, systemic lupus erythematosus, and
dermatomyositis all may be associated with Raynaud’s. The most important thing is for anyone with
Raynaud’s to be carefully evaluated to make sure there is no evidence of an
underlying disease. This can be done by
taking a good history, doing an appropriate physical exam, and by doing
appropriate laboratory testing.
Sometimes
a child has Raynaud’s for many years before a diagnosis of an underlying
disease can be made. There are some
guidelines that doctors use. If
everything is normal there is a less than 10% risk of a disease becoming
evident over time (note these figures are very rough and based on only a single
study). If there is also a positive ANA
the risk rises to about 25%. If there
are nail fold capillary changes on exam the risk is much higher. A few people have distal finger tip pits and
they usually do in fact have disease.
If you
think you have Raynaud’s you should be carefully evaluated by an experienced
rheumatologist. For more information see
My book below.
My
book –click here to order at a discount from Amazon.com!!
at Amazon.com
"A must have for any family with a child
who has a rheumatic disease! I personally found this book to very informative.
Dr. Lehman, as always, gives families a clear understanding of their choice of
treatments and what they can expect from their child's rheumatic disease."—Kathy
Gaither, Juvenile Scleroderma Network, Inc.
“Dr. Tom Lehman’s experience and compassion are evident on every page of this
book, and they help guide the reader—child, parent, and
healthcare professional alike – through the
world of childhood arthritis. This book
is an absolute gem written with a single goal in mind: improve the lives of kids with arthritis.” -- Jack Klippel, M.D. President and CEO of the Arthritis
Foundation
“Dr. Lehman has given parents and families of children with
arthritis the first book that speaks to the parent and child as equals. His book explains the illnesses, the
medications, the lab tests, and the disease course in simple, understandable
lay language and givens them valuable insight into how a pediatric
rheumatologist thinks. Bravo!”-- Charles Spencer, M.D.,
Professor of Clinical Pediatrics,
It’s not just
growing pains.
A guide to childhood muscle, bone, and joint pain,
rheumatic diseases and the latest treatments
Click here to see the table of
contents
It
has always been a frustration trying to answer the many questions I have received
from people over the web. I can’t take the time and give them the
detail I would like to. I have to take
care of my patients. This book is a
distillation of my experience answering questions for parents and health
professionals over 25 years of practice.
If you want to know about the diseases, the tests, the medications, or
how to be sure you are getting the best care– If you are the family member of a
child with joint pains, this book will give you the answers. If
you are a general physician, a pediatrician, or a nurse who cares for children
with these diseases it will answer many of the questions families ask you, and
you can recommend it to them. It will
also answer many of your questions about what shots to give, what precautions
to take, and the other questions families, pediatricians, and other health care
providers have asked me over the years.
Dr. Lehman is
the author of many textbook chapters and articles on the care of children and
young adults with rheumatic diseases including SLE, JRA, dermatomyositis,
scleroderma, Kawasaki disease and related conditions. He practices in New York City. Click here for more
information about Dr. Lehman or the Hospital for Special Surgery.
Click here if you are
interested in making an appointment to see Dr. Lehman
I HOPE THIS INFORMATION IS USEFUL TO YOU.
This site provided by Thomas J. A. Lehman MD
Chief, Division of Pediatric Rheumatology
The Hospital for Special Surgery
535 E 70 St,
212-606-1151, fax 212-606-1938, e-mail goldscout@aol.com
