Signs of self-injurious behavior (SIB), results of pedigree analysis and novel molecular biology with genetic testing (called as Diagnostic triad for LNS), often confirms the diagnosis. Suspicion often comes about when the developmental delay of the individual is associated with hyperuricemia. Otherwise, the diagnosis should be alleged when developmental delay is associated with kidney stones (nephrolithiasis) or blood in the urine (hematuria), caused by uric acid stones. For the most part, Lesch–Nyhan syndrome is first suspected when self-inflicted injury behavior develops. However, self-injurious behaviors occur in other conditions, including nonspecific intellectual disability, autism, Rett syndrome, Cornelia de Lange syndrome, Tourette syndrome, familial dysautonomia, choreoacanthocytosis, sensory neuropathy including hereditary sensory neuropathy type 1, and several psychiatric conditions. Of these, only individuals with Lesch–Nyhan syndrome, de Lange syndrome, and familial dysautonomia recurrently display loss of tissue as a consequence. Biting the fingers and lips is a definitive feature of Lesch–Nyhan syndrome; in other syndromes associated with self-injury, the behaviors usually consist of head banging and nonspecific self-mutilation, but not biting of the cheeks, lips and fingers. Lesch–Nyhan syndrome ought to be clearly considered only when self-injurious behavior takes place in conjunction with hyperuricemia and neurological dysfunction. Diagnostic approach
The urate to creatinine (breakdown product of creatine phosphate in muscle) concentration ratio in urine is elevated. This is a good indicator of acid overproduction. For children under ten years of age with LNS, a urate to creatinine ratio above two is typically found. Twenty-four-hour urate excretion of more than 20 mg/kg is also typical but is not diagnostic.
Anti-vibration gloves in many cases amplify the vibrations at frequencies lower than those mentioned in the text above. Reactive monitoring
A simpler system, known as re-active monitoring, may be used by, for example, monitoring rates of usage of consumable items. Such a system was introduced by Carl West at a fabrication workshop in Rotherham, England. In this system, the vibration levels of the angle grinding tools in use was measured, as was the average life of a grinding disk. Thus by recording numbers of grinding disks used, vibration exposure may be calculated. History
The symptoms were first described by Professor Giovanni Loriga in Italy in 1911, although the link was not made between the symptoms and vibrating hand tools until a study undertaken by Alice Hamilton MD in 1918. She formed her theory through following the symptoms reported by quarry cutters and carvers in Bedford, Indiana. She also discovered the link between an increase in HAV symptoms and cold weather as 1918 was a particularly harsh winter.The first scale for assessing the condition, the Taylor-Pelmear scale, was published in 1975, but it was not listed as a prescribed disease in the United Kingdom until 1985, and the Stockholm scale was introduced in 1987. In 1997, the UK High Court awarded £127,000 in compensation to seven coal miners for vibration white finger. A UK government fund set up to cover subsequent claims by ex-coalminers had exceeded £100 million in payments by 2004. See also
List of cutaneous conditions
Hypothenar hammer syndrome

References
External links
BBC News article on coal miners claims
"Noise and vibration".