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A new criterion proposed for the diagnosis of hand-arm vibration syndrome
T Matoba1, T Ishitake, T Kihara
1Department of Environmental Medicine, Kurume University School of Medicine, Japan.
Insights
This study proposes a new diagnostic criterion for hand-arm vibration syndrome (HAVS) that comprehensively evaluates sensorineural, vascular, and motor disorders. The new HAVS criterion aims for more accurate patient severity assessment compared to existing methods.
Area of Science:
- Occupational Health
- Neurology
- Vascular Medicine
Background:
- Hand-arm vibration syndrome (HAVS) diagnosis relies on criteria like the Stockholm and Ministry of Labour, Japan (MLJ) criteria.
- Existing criteria have limitations, with the Stockholm criterion focusing heavily on Raynaud's phenomenon and the MLJ criterion subdividing milder stages.
- The MLJ criterion considers cold sensation preceding Raynaud's phenomenon and diagnoses HAVS comprehensively across vascular, sensorineural, and motor systems.
Purpose of the Study:
- To propose and evaluate a novel diagnostic criterion for hand-arm vibration syndrome (HAVS).
- To compare the proposed criterion's effectiveness against the MLJ and Stockholm criteria for assessing patient severity.
- To develop a more comprehensive diagnostic approach for HAVS, integrating multiple affected systems.
Main Methods:
- Comparative analysis of patient severity using the proposed criterion against the MLJ and Stockholm criteria.
- Evaluation of diagnostic capabilities for vascular, sensorineural, and motor system disorders.
- Assessment of the grading system for each affected system within the new criterion.
Main Results:
- The Stockholm criterion's focus on Raynaud's phenomenon alone can lead to misclassification of severe vascular cases.
- The MLJ criterion offers better differentiation of early-stage disease and considers pre-Raynaud's symptoms like cold sensation.
- The proposed criterion integrates sensorineural, vascular, and motor system assessments for a comprehensive diagnosis.
Conclusions:
- A new, comprehensive diagnostic criterion for HAVS is proposed, evaluating sensorineural, vascular, and motor systems independently.
- The proposed criterion offers a more holistic approach to diagnosing and grading hand-arm vibration syndrome.
- This new criterion may improve the accuracy of HAVS diagnosis and patient management.
Abstract:
To propose a new criterion for the diagnosis of hand-arm vibration syndrome (HAVS), we evaluated the severity of the patients in comparison with the criterion of the Ministry of Labour in Japan (MLJ) and the Stockholm criterion. The characteristics of the Stockholm criterion was to classify severe cases with vascular disorders, because of evaluation due to the frequency of Raynaud's phenomenon alone. The Stockholm criterion diagnosed the HAVS separately in vascular and sensorineural disorders. The MLJ criterion was able to subdivide light stages. In vascular disorders, the MLJ criterion made serious consideration about cold sensation which appeared long before the occurrence of Raynaud's phenomenon. The MLJ criterion diagnosed the patients with vascular, sensorineural and motor (musculoskeletal) system disorders comprehensively. A new criterion which we proposed includes sensorineural, vascular and motor system disorders, the grade of which is evaluated in each system. The diagnosis might be done comprehensively.