How do You Test for Raynaud’s Disease?

What is Raynaud’s Syndrome?
Raynaud’s is a pan-body phenomenon where the constriction of blood vessels at the extremities of the body results in discolouration of skin like fingertips, nose, toes etc.. It was first discovered by a French doctor in 1862 named Maurice Raynaud. In a person diagnosed with Raynaud’s disease, the body’s response to drop in temperatures is abnormal, leading to numbing and an eventual slowing down of blood circulation to affected areas. The attack may for last 15 minutes or more depending on the severity of the disease.
There are two types of Raynaud’s – Primary and Secondary.

• Primary Raynaud’s may happen in teenage years, from the age of 15 onwards. It is less severe than Secondary Raynaud’s in terms of pain, duration of the attack, management of the disease, etc. It is also not attributed to any underlying medical condition.
• Secondary Raynaud’s is an offshoot of an already pre-existing medical condition. It is pretty severe because the blood vessels are already under stress due to the existing disease. In an extreme case, sores or even gangrene may develop leading to irreversible skin damage. Although amputation is rare, it's not unheard of.

When should you see a doctor?
How do you know that you have Raynaud’s? What symptoms should trigger a visit to the doctor? Well, the answer to that is in plain sight. If you are experiencing any of the below three listed events, you should certainly make an appointment with your physician-

• Sudden numbing of fingers and toes, if exposed to cold
• The affected area turns white and cold for upto 5 minutes
• When finally the attack wears off, prickly or stinging pain is felt.

Identification of Raynaud’s Syndrome

Once you reach out to your doctor regarding your condition, he/she will order a few Raynaud’s tests to conclude the disease. Generally, it is pretty easy to diagnose Raynaud’s but difficult to conclude its type. The Raynaud’s Phenomenon diagnostic tests include the following-

1. Nailfold Capillaroscopy: To determine whether the Raynaud’s is primary or secondary, doctors often rely on this test. In this test, a drop of oil is placed on the nail fold i.e., the area where the nail joins the skin. It is then examined under a microscope or a hand held ophthalmoscope to determine any kind of abnormalities in the capillaries. If the patient has Primary Raynaud’s the result of this test will be normal. However, if the capillaries appear enlarged or abnormal, then it may be deduced as a connective tissue disorder, meaning that the patient is diagnosed with Secondary form of Raynaud’s.When the conclusion is indicative of Secondary Raynaud’s, further tests are prescribed. They generally include a complete blood count, chemistry profile and a urinalysis.

2. Cold Simulation Test: Cold immersion test for Raynaud’s mimics the circumstances in which a Raynaud’s attack might occur. This Raynaud’s syndrome test is so designed that it triggers the symptoms of Raynaud’s. This test in isolation is not enough to prove Raynaud’s. It is conducted in conjunction with other tests.

• To begin with the test, a temperature measuring device is attached to your finger with a tape
• Your hands are immersed in ice cold water.
• After some time, they are removed.
• The time taken for the hands to return to normal temperature is recorded by the device.
• The time recorded by the device will confirm the incidence of Raynaud’s disease.

3. Antinuclear Antibodies Test: This is one of Raynaud’s blood test commonly prescribed by the doctor. If you test positive for these antibodies, it reflects a stimulated immune system. This is often found in patients having an underlying history of autoimmune diseases and connective tissue disorders.

4. Erythrocyte Sedimentation Rate: To confirm secondary Raynaud’s, this is another blood test used. It measures the settling rate of Red Blood Cells (RBC’s) at the floor of the test tube. A rate that is faster than the normal indicates an inflammatory condition or an autoimmune disease, thereby predisposing you to develop Raynaud’s symptoms.

Generally, these tests are enough to conclude the presence or absence of Raynaud’s Phenomenon. However, if the doctor wishes, they may prescribe other tests as well. But one shouldn’t be panicked by any of them. For it is only after your diagnosis is confirmed that one may begin the restorative therapy!