Review of different quantification methods for the diagnosis of digital vascular abnormalities in hand-arm vibration syndrome.

OBJECTIVE This study was undertaken to review the diagnostic ability of different quantification methods in the assessment of vibration-induced white finger (VWF), the typical clinical manifestation of vascular injuries in Hand-arm Vibration Syndrome (HAVS). METHODS A literature search of original and major review articles related to the quantification techniques for diagnosing vascular injuries in HAVS was performed. Relevant data from the publications were extracted and included in this study for reporting and discussion. RESULTS Few studies were available to substantiate the diagnostic techniques using the nail press test and nailfold capillaroscopy. Also, few studies were found to conclusively demonstrate the diagnostic ability using thermometry and thermography incorporated with cold provocation. Some recent reports raised the question regarding the diagnostic ability of finger plethysmography; but by virtue of its comparable assessment parameters and better diagnostic performance, plethysmography appears to be a suitable diagnostic method. In noninvasive quantification of vascular injuries, diagnostic techniques like laser Doppler perfusion imaging and nailfold capillaroscopy require further evaluation in future studies. CONCLUSIONS For a reliable objective diagnosis of VWF at present, quantification of vascular responses using a test battery including established methods like thermometry or thermography and strain gauge plethysmography appears to be useful.