Raynaudís Phenomenon

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 Dr. Lehman is the author of many textbook chapters and articles on the care of children and young adults with Raynaudís and associated rheumatic diseases.He practices in New York City.Click here for more information about Dr. Lehman or the Hospital for Special Surgery.

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Raynaudís is described as Raynaudís disease, Raynaudís phenomenon, or Raynaudís syndrome.Although some people carelessly use these terms interchangeably, these arenít all the same thing.Whatís going on?It helps to know a little history.Raynaud was a French medical student in the late 1800ís 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 Raynaudís 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 Raynaudís.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.


Raynaudís phenomenon describes the color changes.When they occur without any other problem it is called Raynaudís disease.However if the color changes occur in someone who has another rheumatic disease then it is called Raynaudís syndrome.Raynaudís disease is a minor inconvenience, which is not terribly important.Raynaudís syndrome is significant because of whatever disease it is associated with.


Many people come to medical attention because of Raynaudís and it is not initially clear whether they have an underlying rheumatic disease or simply Raynaudís disease.Almost any rheumatic disease can be associated with Raynaudís.Rheumatoid arthritis, scleroderma, systemic lupus erythematosus, and dermatomyositis all may be associated with Raynaudís.The most important thing is for anyone with Raynaudís 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 Raynaudís 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 Raynaudís you should be carefully evaluated by an experienced rheumatologist.For more information see My book below.


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"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."óKathy Gaither, Juvenile Scleroderma Network, Inc.

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Itís not just growing pains.
A guide to childhood muscle, bone, and joint pain,
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It has always been a frustration trying to answer the many questions I have received from people over the web.I canít 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 careĖ 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.

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This site provided by Thomas J. A. Lehman MD
Chief, Division of Pediatric Rheumatology
The Hospital for Special Surgery
535 E 70 St,
New York, NY 10021
212-606-1151, fax 212-606-1938, e-mail goldscout@aol.com

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