features suggesting secondary to connective tissue disorder

Last reviewed 05/2021

These include:

  • development of Raynaud's phenomenon (RP) at an older age (i.e. > 30 years old), and particularly in males, suggests the possibility that RP is secondary to some underlying connective tissue disease (CTD), and this should prompt investigation for an underlying cause

    • RP occurs in more than 90% of patients with systemic sclerosis and in up to 40% of cases with systemic lupus erythematosus and idiopathic inflammatory myositis

  • other additional features that makes a secondary cause of RP more likely include:

    • digital ulceration, or year-round symptoms
    • abnormal nail fold capillaries (viewed with an ophthalmoscope with the +20 lens)
    • asymmetric upper limb pulses or bruits
    • puffiness/tightness of the finger skin
    • elevated ESR
    • positive ANA or other antibodies (Ro/La/Scl-70 etc)

Reference:

  • 1) Arthritis Research Campaign (2000). Rheumatic Disease In Practice, September 2000, 3.