Objectives The internationally accepted Stockholm vascular grading scale for vibration white finger (VWF) has shortcomings that have received insufficient attention : some of its key descriptors require further definition and, more crucially, the scale does not suit all possible patterns of symptoms.
To determine whether these shortcomings matter in practice, an attempt was made to apply the Stockholm vascular scale to 92 consecutive cases of VWF assessed by one area office of the Health and Safety Executive in the United Kingdom.
Methods Case definition was based on clinical history and examination, but blanching was confirmed from observations of 34 men (37% of the cases).
The 145 affected hands were graded under 2 alternative definitions of « frequent attacks » ; and the 92 persons were graded using the same definitions according to the extent of blanching in their worse affected hand.
Results Depending on the choice of definition of frequent attacks, between 36% and 61% of the affected hands fell outside the scale and were unclassifiable.
Thirty percent of the individual cases could not be classified under either definition, and 28% altered their grading according to the definition.
The findings were broadly similar when the analysis was restricted to the 34 cases with observed blanching. (...)
Mots-clés Pascal : Raynaud maladie, Vibration, Exposition professionnelle, Echelle évaluation, Indice gravité, Diagnostic, Membre supérieur, Homme, Médecine travail, Appareil circulatoire pathologie, Vaisseau sanguin pathologie, Capillaire sanguin pathologie, Peau pathologie, Système nerveux autonome pathologie, Acrosyndrome
Mots-clés Pascal anglais : Raynaud disease, Vibration, Occupational exposure, Evaluation scale, Severity score, Diagnosis, Upper limb, Human, Occupational medicine, Cardiovascular disease, Vascular disease, Capillary vessel disease, Skin disease, Diseases of the autonomic nervous system, Acrosyndrome
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0079137
Code Inist : 002B12B03. Création : 14/05/1998.