Assessment of microvascular changes in Raynaud's phenomenon and connectivetissue disease using colour Doppler ultrasound

Objective. We used colour Doppler ultrasound (CDU) to differentiate primary from secondary Raynaud's phenomenon (pRP and sRP, respectively) and to ass ess digital vascular damage in patients with connective tissue disease (CTD ). Methods. Vascularity in the nailbeds of 15 healthy controls and 35 patients with CTD (systemic sclerosis or systemic lupus erythematosus) was quantifi ed using a multi-D array transducer before and after cold and warm challeng e, respectively. The results were compared with the clinically evaluated in itial skin lesions. Vascularity was compared similarly between 10 pRP and 2 2 sRP patients. Results. Vascularity at ambient temperature differed between healthy subjec ts and sRP patients as well as between healthy subjects and CTD patients wi thout initial skin lesions. Patients with pRP had normal vascularity at amb ient temperature but differed from healthy controls in response to a dynami c temperature challenge. CDU confirmed the clinical evaluation in 89.4% of the patients with RP and in 78.0% of the skin lesions. Conclusion. The novel CDU technique presented here makes it possible to dis criminate between pRP and sRP and to quantify vascular changes in CTD patie nts.