Document Detail


The 'distal-dorsal difference': a thermographic parameter by which to differentiate between primary and secondary Raynaud's phenomenon.
MedLine Citation:
PMID:  17018538     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To test the hypothesis that in a patient with Raynaud's phenomenon (RP), a difference of >1 degrees C between the fingertips and the dorsum of the hand ['distal-dorsal difference' (DDD), fingers cooler] is specific for underlying structural vascular disease as occurs in systemic sclerosis (SSc), and to evaluate other thermographic parameters in the separation of secondary from primary RP. METHODS: A retrospective analysis of the case notes and thermography results of patients attending thermography, primarily over a 2-yr period. Multinomial logistic regression was used to ascertain whether thermography variables differed between groups with primary RP (56 patients), undifferentiated connective tissue disease (21 patients) and SSc (45 patients), with adjustment for age, sex and smoking. RESULTS: A DDD >1 degrees C in any finger at 30 degrees C had a positive predictive value of 70%, and a negative predictive value of 82%, in identifying the patient with RP secondary to SSc. From the results of the multinomial logistic regression, a score was derived incorporating age, number of fingers with DDD >1 degrees C at 30 degrees C and maximum rewarming gradient. This score (with a suitable cut-off) was 82% sensitive and 82% specific in identifying RP secondary to SSc, with a positive predictive value of 73% and a negative predictive value of 89%. CONCLUSION: Parameters derived from thermography (incorporating both a heat and cold challenge) aid in the prediction of SSc in patients with RP.
Authors:
M E Anderson; T L Moore; M Lunt; A L Herrick
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Publication Detail:
Type:  Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't     Date:  2006-10-02
Journal Detail:
Title:  Rheumatology (Oxford, England)     Volume:  46     ISSN:  1462-0324     ISO Abbreviation:  Rheumatology (Oxford)     Publication Date:  2007 Mar 
Date Detail:
Created Date:  2007-02-19     Completed Date:  2007-05-09     Revised Date:  2007-09-06    
Medline Journal Info:
Nlm Unique ID:  100883501     Medline TA:  Rheumatology (Oxford)     Country:  England    
Other Details:
Languages:  eng     Pagination:  533-8     Citation Subset:  AIM; IM    
Affiliation:
University of Liverpool Adademic Rheumatology Unit, University Hospital Aintree, Liverpool, UK.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Diagnosis, Differential
Epidemiologic Methods
Female
Fingers
Hand
Humans
Image Processing, Computer-Assisted
Male
Middle Aged
Raynaud Disease / diagnosis*,  etiology*
Scleroderma, Systemic / complications*,  diagnosis*
Skin Temperature
Thermography

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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