PubMed1998
BACKGROUND: Frequent use of vibrating tools over several years may lead to a neurovascular disturbance of finger circulation with the development of typical Raynaud's phenomenon, attacks being triggered by vibration and/or cold exposure. The condition is recognized as an occupational disease and known as vibration-induced white finger (VWF). Aim of the present study was to evaluate the usefulness of infrared thermography (IRT) with a cold provocation test in the diagnosis of Raynaud's phenomenon in VWF. PATIENTS AND METHODS: 24 patients with the diagnosis of VWF, previously established by other methods, were compared with 12 matched control subjects. We carried out IRT-measurements simultaneously on both hands before, directly after and 5, 10, 15, 20, and 30 mins following a 3 min exposure of both hands to a waterbath of 12 degrees C. The results of temperature measurements of all fingers were analyzed and the time to complete rewarming of all fingers was recorded. RESULTS: The basal thermograms did not differ between both groups, whereas the mean finger temperatures after cold exposure were significantly lower in VWF-patients compared to controls, with a considerable individual overlap between both groups. Therefore, determination of absolute finger temperature reveals not to be a useful diagnostic tool in individual cases, but might be helpful for pharmacological studies (group-analysis). In contrast to absolute finger temperatures, the parameter of rewarming time after cold exposure revealed to be diagnostic on an individual basis: a complete rewarming after 15 min indicates a normal vascular reactivity and an incomplete rewarming 30 min following the cold provocation points to an impaired vascular reactivity due to VWF. CONCLUSIONS: IRT revealed to be a useful tool in the diagnosis of Raynaud's phenomenon in VWF, and provides a sufficient documentation suitable for further follow-up examination.