小结
定义
病史和体格检查
关键诊断因素
- 存在的危险因素
- 肢端疼痛/不适
- 肢端感觉异常
- 肢端苍白
- 肢端出现潮红和/或青紫变色
- 甲床毛细血管扩张
- 界限清楚的变色
- 放大甲床
其他诊断因素
- 烧心
- 吞咽困难
- 手部肿胀
- 皮肤紧绷
- 关节痛
- 光敏感性
- 口腔/鼻腔溃疡
- 脱发
- 蝶形红斑
- 指端硬化
- 毛细血管扩张
- 胸膜炎性胸痛
- 肢端溃疡
- 肢端凹坑
- 肢端簇吸收
- 指尖/手指坏疽
- 指尖凸起疼痛的红色病变
- 自动截肢
危险因素
- 女性
- 家族史
- 结缔组织病
- 振动损伤
- Buerger 病
- 长时间的寒冷暴露/冻伤
- 寒冷气候
- 吸烟
- 缺血
- 偏头痛
- 青光眼
诊断性检查
首要检查
- 临床诊断
- 抗核抗体
- 全血细胞计数（FBC）
- 红细胞沉降率
- 肌酐
- 尿液分析
治疗流程
重度继发性 RP：严重缺血伴肢端溃疡或面临肢端缺损的危险
原发性或轻度继发性 RP
撰稿人
作者
Janet Pope, MD, MPH, FRCPC
Professor of Medicine
Division of Rheumatology
Department of Medicine
University of Western Ontario
Schulich School of Medicine and Dentistry
Head
Division of Rheumatology
St. Joseph's Health Care
London
Ontario
Canada
利益声明
JP has attended advisory boards for Actelion, the manufacturer of bosentan. JP is an author of a number of references cited in this topic.
同行评议者
Ariane L. Herrick, MD FRCP
Reader in Rheumatology and Consultant Rheumatologist
Musculoskeletal Research Group
University of Manchester
Manchester
UK
利益声明
ALH has been a paid speaker for Actelion; a consultant for Actelion and Pfizer; and an investigator in studies sponsored by Actelion, Mediquest, and United Therapeutics. ALH is an author of a number of references cited in this topic.
Bridget Griffiths, MB ChB, MD, MRCP(UK)
Consultant Rheumatologist
Department of Rheumatology
Freeman Hospital
Newcastle upon Tyne
UK
利益声明
BG declares that she has no competing interests.
Kim Olson, MD
Intern
Veterans Administration Hospital
Minneapolis
MN
利益声明
KO declares that he has no competing interests.
Thomas Osborn, MD
Associate Professor
Department of Medicine
Mayo Clinic
Rochester
MN
利益声明
TO declares that he has no competing interests.
Philip Seo, MD, MHS
Assistant Professor of Medicine
Division of Rheumatology
Johns Hopkins University School of Medicine
Co-Director
Johns Hopkins Vasculitis Center
Baltimore
MD
利益声明
PS declares that he has no competing interests.
鉴别诊断
- 对寒冷的正常反应
- 紫绀/冷球蛋白血症
- 冻疮（冻伤病）
更多 鉴别诊断指南
- 专家建议的系统性硬化症治疗流程
- ESVM 指南 - 雷诺现象的诊断和管理
更多 指南患者教育信息
雷诺现象
戒烟
更多 患者教育信息
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