In the setting of new onset severe Raynaud’s with digital ischemia (partial toe amputation), but negative initial rheumatologic evaluation, what additional rheumatologic or hematologic workup should be considered?

This is always a difficult situation. As Rheumatologists, we tend to lean hard on the laboratories, but in cases like this it is the history and physical examination which tell the better story. The history is critical here, since a smoking / tobacco history gives a lot of information. Any history o...