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.