How to diagnose NFCI
There are no objective diagnostic tests for NFCI. As such, NFCI is a clinical diagnosis based on a collection of symptoms and signs, and in which the medical history is key (including timing, severity and duration of exposure, symptom sequence) and solely determines the diagnosis in 80% of cases.
NFCI diagnostic criteria are based upon information gathered from published scientific papers, expert opinion and the experience gained from running UK cold injury clinics for over 10 years.
NFCI Diagnostic Criteria:
- Affected part has become cold to the point of loss of feeling/sensation for at least one hour (NB a substantially longer duration is generally involved).
- Rewarming pain that persists for longer than 30 minutes.
- Neurological symptoms such as tingling, burning, pins and needles, reduced or altered sensation persist beyond 48 hours.
NFCI is excluded if sensation returns to normal when warm within the first 48 hours post cooling event.
It is important to exclude Raynaud’s Phenomenon (RP) in accordance with International Diagnostic Consensus Criteria [1].
NFCI clinics
The Neuropathic Pain Clinic at Chelsea and Westminster Hospital NHS Foundation Trust
369 Fulham Road, London SW0 9NH.
We accept NHS referrals for diagnostic assessment of neuropathy and neuropathic pain in cases of NFCI. We also provide multidisciplinary management of neuropathic pain. We accept civilian, veteran and serving military cases (referrals for serving military personnel only from Defence Medicine NFCI regional clinics). We do not provide medicolegal reports or see private patients. The consultant in charge to whom referrals should be made is Dr Harriet Kemp (chelwest.cwpainmgmtadmin@nhs.net). Prof Andrew Rice is a clinical advisor to the clinic.