Lead

Nineteen consecutive patients claiming compensation for vibration white finger were reviewed. The cold provocation test was found to be of no value in confirming a diagnosis of vibration white finger. Small cysts were apparent on the radiographs in 61 % of patients ’ wrists but none had developed significant degenerative changes of the wrist or digits. In this group of claimants, 63 % had carpal tunnel syndrome on nerve conduction studies. Vibration white finger was accepted by the Department of Health and Social Security of the United Kingdom as a prescribed occupational disease in April, 198.5. The condition is known by a variety of names including white finger, dead finger and episodic digital ischaemia. It describes a condition in which episodic transient blanching of the fingers occurs, precipitated by cold, following prolonged exposure to hand or arm vibration. It is a form of secondary Raynaud’s phenomenon. TABLE 1 Causes of Secondary Raynaud’s Phenomenon Maurice Raynaud first described the condition of digital blanching on exposure to cold in 1862. Primary Raynaud’s phenomenon, or Raynaud’s disease is a common condition affecting 5-10 % of the population; it is generally familial, bilateral and symmetrical. It is much more common in females. In general, the onset is early: 60 % by the age of 30 years. It is distinguished from secondary Raynaud’s phenomenon by the above-mentioned features and an absence of predisposing conditions. 1. Vascular disease 2. Vascular obstructio