Juvenile rheumatoid ahritisREF: Schwaz's Principles of Surgery 9' edition Chapter 23. Aerial Disease, Harrison's Internal Medicine 17th edition Chapter 243 Table 243-1 "Raynaud's phenomenon is seen in Rheumatoid ahritis not Juvenile Rheumatoid ahritis" The term Raynaud's phenomenon applies to a heterogeneous symptom array associated with peripheral vasospasm, more commonly occurring in the upper extremities The majority of patients are young women <40 years of age and is often bilateral. There is no cure for Raynaud'ssyndrome, thus all treatments mainly palliate symptoms and decrease the severity and, perhaps, frequency of attacks. The majority (90%) of patients will respond to avoidance of cold and other stimuli. The remaining 10% of patients with more persistent or severe syndromes can be treated with a variety of vasodilatory drugs. Calcium-channel blockers such as diltiazem and nifedipine are the drugs of choice. Raynaud's phenomenon is broadly separated into two categories: the idiopathic variety, termed Raynaud's disease, and the secondary variety, which is associated with other disease states or known causes of vasospasm CLASSIFICATION OF RAYNAUD'S PHENOMENON Primary or idiopathic Raynaud's phenomenon: Raynaud's disease Secondary Raynaud's phenomenon Collagen vascular diseases: scleroderma, systemic lupus erythematosus, rheumatoid ahritis, dermatomyositis, polymyositis Aerial occlusive diseases: atherosclerosis of the extremities, thromboangiitis obliterans, acute aerial occlusion, thoracic outlet syndrome Pulmonary hypeension Neurologic disorders: interveebral disk disease, syringomyelia, spinal cord tumors, stroke, poliomyelitis, carpal tunnel syndrome Blood dyscrasias: cold agglutinins, cryoglobulinemia, cryofibrinogenemia, myeloproliferative disorders, WaldenstrOm's macroglobulinemia Trauma: vibration injury, hammer hand syndrome, electric shock, cold injury, typing, piano playing Drugs: ergot derivatives, methysergide, Beta-adrenergic receptor blockers, bleomycin, vinblastine, cisplatin