A female patient presented with Raynaud’s phenomenon in the emergency depament. All of the following clinical conditions exhibit Raynaud’s phenomenon, EXCEPT:
Correct Answer: Juvenile rheumatoid ahritis
Description: Raynaud's phenomenon (RP) is the clinical syndrome of episodic color changes of the digits in response to cold. It can be primary, or it may be secondary to an autoimmune disorder (scleroderma, systemic lupus erythematosus , Sjogren's syndrome, dermatomyositis, polymyositis, or rheumatoid ahritis or to chronic exposure to mechanical vibration (e.g., jackhammer operators). Patients classically present with initial acute, well-demarcated pallor of the digits that progresses to painful cyanosis and, finally, to red flushing and pain on reperfusion. Patients with secondary Raynaud's phenomenon usually have more symptoms and have dilatation of the capillary bed at the base of the fingernails. Ref: Greenberg's Text-Atlas of Emergency Medicine By Michael I. Greenberg, M.D., 2005, Page 796; Schwaz's Principles of Surgery, 9th edition, Chapter 23, Aerial Disease; Harrison's Internal Medicine, 17th edition, Chapter 243, Table 243-1.
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Surgery
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