Diagnostic value of finger thermometry and photoplethysmography in the assessment of hand-arm vibration syndrome.

Digital photoplethysmography and skin thermometry are both measures of circulation in the skin of the fingers. These methods and a cold provocation test were performed on 29 chain-saw workers grouped in stages 0, 1, 2, or 3 according to the Stockholm Workshop scale of hand-arm vibration syndrome, and on 16 controls. The reduction of photoplethysmographic amplitude after the cold test reflects the degree of vasoconstriction, and the recovery rate demonstrates passive vasodilatative capacity. Both tests were found to distinguish all vibration--exposed subjects, including those without clinically manifest vibration-induced white fingers, from the controls. With a 75% reduction in photoplethysmographic amplitude as a discriminating threshold, the sensitivity for the detection of Raynaud's phenomenon was 62% and the specificity, 87%. The discriminating threshold of 90% for recovery rate yielded a sensitivity of 69% and a specificity of 72%.