Findings that may identify a patient who is more likely to show transition ("progression") from primary to secondary Raynaud's phenomenon include:
(1) abnormal nailfold capillaries
(2) positive antinuclear antibody (ANA), especially if the titer is high
(3) positive Allen test (delayed or reduced intensity of red color of hands after release of occluded blood flow)
(4) older age at onset of the Raynaud's
(5) more severe Raynaud's findings at onset
(6) abnormal findings on one or more thoracic outlet tests (Adson test, costoclavicular test or pectoralis test)
(7) hand and/or finger swelling
Secondary diagnoses may include:
(1) scleroderma
(2) mixed connective tissue disease (MCTD)
(3) SLE
(4) rheumatoid arthritis (RA)
(5) Sjogren's syndrome
(6) paraproteinemia or cryoproteinemia
(7) undifferentiated connective tissue disease (UCTD)
(8) CREST syndrome
Findings seen in patients who developed systemic sclerosis (scleroderma):
(1) abnormal nailfold capillaries
(2) hand and/or finger swelling
(3) anti-topoisomerase I (Scl-70 or Scl-86)
Findings seen in patients who developed CREST syndrome:
(1) anti-centromere antibodies:
Findings in patients who developed SLE:
(1) anti-Sm
(2) anti-U1-RNP
