It's not Just Growing Pains: A Guide to Childhood Muscle, Bone, and Joint Pain, Rheumatic Diseases, and the Latest Treatments

By Thomas J. A. Lehman | Go to book overview

14
Raynaud’s
Phenomenon

Maurice Raynaud (1834–1881) was a French medical student in the 1860s who was required to write a thesis to fulfill the requirements for graduation from medical school. He described the color changes he noticed in the hands of some women while standing outside in the cold waiting for the street car during the winter in Paris. Raynaud’s phenomenon refers to the typical hand changes he described. Raynaud’s disease (primary Raynaud’s) refers to the typical hand changes occurring in the absence of any other rheumatic disease. Raynaud’s syndrome (secondary Raynaud’s) refers to the typical changes occurring in the setting of an underlying rheumatic disease.

Many people experience cold hands whenever it is cool outside. This is not Raynaud’s phenomenon. Raynaud’s phenomenon results from spasm of the blood vessels in response to something happening. The vessels may spasm as a result of exposure to the cold, embarrassment, or another stress. The fundamental abnormality is the hyperreactivity of the blood vessels. Raynaud’s may be the result of being thin (it is common for tall, thin women to have Raynaud’s phenomenon) or of the blood vessels being sensitized by immune complexes or by inflammatory mediators (see Chapter 24) because the individual has an underlying rheumatic disease.

To have true Raynaud’s phenomenon, there must be a three-phase color change. Initially, the tips of one or more fingers turn white as the blood flow is cut off by spasm of the blood vessels. Once the spasm passes, there is increased reactive blood flow and the fingers turn red then slowly back to their normal state of bluish discoloration, with sluggish blood flow.

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