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Raynaud’s Mimics

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Raynaud’s Phenomenon

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Abstract

Raynaud’s phenomenon is a common feature among many autoimmune conditions and is often used to support the diagnosis of a rheumatic disease. Temperature sensitivity and digital discoloration, two key features of Raynaud’s, are shared by several other conditions which may complicate a clinical evaluation. An accurate diagnosis of Raynaud’s is critical in risk stratifying patients with early rheumatic disease and determining appropriate management. Physicians and other health care providers must be aware of these “mimics” and clearly distinguish them from Raynaud’s. This chapter begins with a detailed review of each of these conditions which include frostbite, primary pernio/chilblains, chilblain lupus, acrocyanosis, livedo reticularis and racemosa, and erythromelalgia.

Subsequently, the chapter will address other mimics of Raynaud’s that are also associated with digital color changes, but are distinguished from Raynaud’s by an absence of temperature sensitivity. Thoracic outlet syndrome and complex regional pain syndrome are both discussed in detail and important features of diagnosis and management are revealed. Thoracic outlet syndrome is important to accurately diagnose as it can be reversed with surgical intervention. Out of the three subtypes, arterial TOS is most important to quickly refer to a surgeon. Complex regional pain syndrome can have similar features to Raynaud’s, but the quality of the pain is the most distinguishing symptom.

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Abbreviations

CRPS:

Complex regional pain syndrome

FRRS:

First rib resection and anterior scalenectomy

IASP:

International Association for the Study of Pain

QSART:

Quantitative sudomotor axon reflex tear

RSO:

Resting sweat output

RST:

Resting skin temperature

TOS:

Thoracic outlet syndrome

TRVP:

Transient receptor vanilloid channels

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Acknowledgement

 We acknowledge Dr. Stefan Zimmeran for his image of arterial thoracic outlet syndrome as shown in (Fig. 11.9).

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Authors and Affiliations

  1. Department of Medicine, Division of Rheumatology, John Hopkins School of Medicine, Baltimore, MD, USA

    Zsuzsanna H. McMahan M.D. & Julie J. Paik M.D.

  2. The Johns Hopkins Scleroderma Center, 5200 Eastern Avenue, Mason Lord Building, Center Tower, Suite 4100, Baltimore, MD, 21224, USA

    Zsuzsanna H. McMahan M.D.

Authors
  1. Zsuzsanna H. McMahan M.D.
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  2. Julie J. Paik M.D.
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Correspondence to Zsuzsanna H. McMahan M.D. .

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Editors and Affiliations

  1. School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA

    Fredrick M. Wigley

  2. Department of Rheumatology, The University of Manchester, Manchester, United Kingdom

    Ariane L. Herrick

  3. Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medic, Baltimore, Maryland, USA

    Nicholas A. Flavahan

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McMahan, Z.H., Paik, J.J. (2015). Raynaud’s Mimics. In: Wigley, F., Herrick, A., Flavahan, N. (eds) Raynaud’s Phenomenon. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-1526-2_11

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  • DOI: https://doi.org/10.1007/978-1-4939-1526-2_11

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