Diagnostic performance of cold provocation test with hands immersion in water at 10 degree C for 5 min evaluated in vibration-induced white finger patients and matched controls

Purpose: This study aimed to explore the diagnostic ability of the cold provocation test with hands immersion in water at 10 degree C for 5 min in diagnosing vibration-induced white finger (VWF). Methods: Finger skin temperature (FST) was measured in 20 VWF patients and 20 matched healthy controls, at palmar side of the distal phalanges of fingers from both hands before, during, and after hands immersion in water at 10 degree C (for 5 min with waterproof coverings put on both hands). Data from 4 fingers (except thumb) were evaluated at five time points: just before immersion, last minute during immersion, and at 5th, 10th, and 15th min during the post-immersion or recovery period. Results: A positive group difference between patients and controls was revealed during the recovery period. During recovery at 95 and 70% specificity, the sensitivity ranged from 20 to 30% and 50 to 70% for evaluation with average FST for 4 fingers and 15-35% and 60-65% for evaluation with minimum FST among 4 fingers, respectively. Overall, evaluation of absolute FST at 15th min of recovery offered better diagnostic ability. Conclusions: The cold provocation test with hands immersion in water at 10 degree C for 5 min could discriminate VWF patients from healthy controls; however, this test has a limited diagnostic value in diagnosing patients with VWF.