Michigan Medicine

healthcare 📍 Ann Arbor, United States
2
EM Publications
0
EM Researchers

Associated Institutions

University of Michigan
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Women's Hospital
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A. Alfred Taubman Health Care Center
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Michigan Center for Translational Pathology
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C. S. Mott Children's Hospital
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Publications

Painful Raynaud's mimics.

Zahn C, Puga C, Malik A, Khanna D
Best practice & research. Clinical rheumatology

Raynaud's syndrome is a common finding in many autoimmune conditions. Accurately diagnosing Raynaud's, and differentiating it from mimicking conditions, is imperative in rheumatologic diseases. Raynaud's syndrome and Raynaud's mimickers, especially painful Raynaud's mimickers, can prove a diagnostic challenge for the practicing rheumatologist. Painful Raynaud's mimickers can lead to increased patient stress and unnecessary medical work up; Healthcare providers need to be aware of Raynaud's mimickers when evaluating patient concerns of skin color changes and pain. The present narrative review aims to highlight Raynaud's syndrome, important painful mimickers that may be seen, diagnosis, and updated management recommendations.

Resolution of refractory symptoms of secondary erythermalgia with intermittent epidural bupivacaine.

Stricker LJ, Green CR
Regional anesthesia and pain medicine

Erythermalgia is a rare disorder characterized by erythema, edema, elevated skin temperature, and burning pain of the hands and/or feet. The etiology of primary erythermalgia is idiopathic while secondary erythermalgia is associated with autoimmune and rheumatologic factors. Symptoms are typically refractory to medical management. We report the use of epidural bupivacaine as a treatment option for secondary erythermalgia. A 28-year-old woman presented with secondary erythromelalgia that was characterized by severe pain, swelling, and erythema. Medical management failed and a lumbar epidural dosed with bupivacaine was used. This resulted in complete resolution of the patient's symptoms. Intermittent epidural bupivacaine may provide treatment of the refractory symptoms of secondary erythermalgia.