Barbara Ruaro et al. density in multiple sclerosis. Acta Neurol Scand juxta-articular metacarpal bone in patients with 2018;137:3639. limited systemic sclerosis: a cross-sectional study. J Musculoskelet Neuronal Interact 2014;14: 43 Heise V, Galli-Lysak I, Villiger PM, Aeberli D. Increased 18994. bone mineral density at the hypoxia prone site of the Rheumatology 2018;57:1554 doi:10.1093/rheumatology/key029 Clinical vignette Advance Access publication 28 February 2018 Longitudinal nailfold capillaroscopy tracking of FIG.1 High-magnification nailfold mosaic sequence cov- microangiopathic changes in systemic sclerosis ering a near 10-year period A 51-year-old female with a 20-year history of lcSSc (RP, sclerodactyly, digital pitting, ACA, abnormal nailfold capil- laries) had no history of digital ulceration but developed calcinosis of several fingers. RP was relatively mild. Regular high-magnification (300) capillaroscopic as- sessment (for research purposes) was recorded from 2002, 4 years post-diagnosis. The microscope system used throughout was a modified KK Technology system, Honiton, Devon, UK, with green LED illumination for max- imum contrast and custom software allowing whole-nail- fold mosaic images to be captured . Seven images of the non-dominant ring finger were captured during the 9.9 year period ending August 2012 (See Fig. 1). The image sequence describes the progression of the nailfold microvasculature from an early/active scleroderma pattern  initially, with many enlarged and giant capil- laries, through a period of relative avascularity, concluding with evidence of neoangiogenesis by the final image, and demonstrates the potential of capillaroscopy as a bio- marker of microvascular disease. This tracking of change is possible via the image capture system, which combines high magnification with a whole nailfold view. Capillaroscopy provides a unique non-invasive window into evolution of SSc pathogenesis over time: in this pa- tient, microvascular disease progression might be driving Images are recorded at 300 magnification, giving a development of calcinosis. resolution of approximately 1 mm/pixel. Mosaics are built up from individual camera frames and then stitched Funding: No specific funding was received from any automatically in software to create the pan-nailfold bodies in the public, commercial or not-for-profit sectors images seen above. Vertical red lines are superimposed to carry out the work described in this manuscript. on the sequence as a visual aid, linking the same vessels in each image. Blue scale bars representing 0.5 mm are Disclosure statement: The authors have declared no shown below each nailfold image. conflicts of interest. 1 2 Graham Dinsdale , Anniek M. van Roon , Correspondence to: Graham Dinsdale, The University of 1 3 Andrea Murray , Christopher Taylor and Manchester, Clinical Science Building, Salford Royal NHS 1,4 Ariane L. Herrick Foundation Trust, Stott Lane, Manchester M6 8HD, UK. E-mail: firstname.lastname@example.org Centre for Musculoskeletal Research, The University of Manchester, Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK, References Department Internal Medicine, Division of Vascular Medicine, University of Groningen, University Medical Centre, 1 Anderson ME, Allen PD, Moore T et al. Computerized Groningen, The Netherlands, Centre for Imaging Sciences, nailfold video capillaroscopy - a new tool for assessment Division of Informatics, Imaging & Data Sciences, The of Raynaud’s phenomenon. J Rheumatol 2005;32:8418. University of Manchester and NIHR Manchester Musculoskeletal Biomedical Research Centre, Manchester 2 Cutolo M, Sulli A, Smith V. How to perform and interpret University NHS Foundation Trust, Manchester Academic capillaroscopy. Best Pract Res Clin Rheumatol Health Science Centre, Manchester, UK 2013;27:23748. ! The Author(s) 2018. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: email@example.com 1554 https://academic.oup.com/rheumatology Downloaded from https://academic.oup.com/rheumatology/article-abstract/57/9/1554/4913819 by Ed 'DeepDyve' Gillespie user on 28 August 2018
Rheumatology – Oxford University Press
Published: Sep 1, 2018
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