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Bedeutung der Anamnese bei der Diagnostik des Vibrationsbedingten Vasospastischen Syndroms (VVS)

Introduction: For the diagnosis of vibration-induced white finger (VWF), the medical anamnesis is of central importance. By means of retrospective analysis in the largest study of this kind that has been carried out in Germany to date, the importance of anamnestic information was to be checked. Methods: Data collection was carried out retrospectively using a standard questionnaire (n = 317, observation period: 1984 to 2002, median examination interval: 2 years). In addition, thermometric measurements of all ten fingers in a standardized cold provocation test were evaluated. The ages of the patients ranged from 21 to 74 years of age (median: 56 years). 98.4 % of the collective was male and 1.6 % was female. 43.0 % of the patients were non-smokers, 35.7 % smokers and 21.3 % ex-smokers. Median daily consumption of alcohol was 6.4 g. 67.8 % of the patients had worked in the forestry industry, 13.6 % as stonemasons and the remaining 18.4 % had other professions. Results: The symptoms typical for VWF and the dependence of attacks on season and low outdoor temperatures could be confirmed. Contrary to published data, we found that the maximum duration of an attack could be longer than 1 hour. The rewarming process followed a similar course in all fingers. The subjective assessment of the severity of the attacks is not a reliable parameter. Lack of or poor association was found between thermometrically measured results and the subjective assessment of the severity of the disease or of the effects on the most affected finger. Conclusions: As there are typical symptoms for this disease, medical history is of central importance. Because of the bad association between subjective information and objective examination results, objective tests should be applied more thoroughly in order to diagnose and stage this disease.