Nailfold Capillaroscopic Findings in an Orthopedic Surgeon: Reversible Abnormalities after the Cessation of Radiation Exposure

Raynaud's phenomenon in a drummer player: Microvascular disorder and nailfold video capillaroscopic findings

Drummers are usually exposed to intensive physical stress and occupational diseases that have been only partially investigated. The majority of studies focus on musculoskeletal problems while microvascular abnormalities have been less considered. We report on a case of a 19-year-old drummer affected by Raynaud's phenomenon. The patient underwent nailfold video capillaroscopy that showed a non-specific pattern, with granular flow, dyshomogeneous capillary morphology, increased efferent/afferent loop ratio and many enlarged capillaries. The continuous exposition to vibration in drummers could determinate microvascular abnormalities with related cold induced disorders and Raynaud's phenomenon. Nailfold video capillaroscopy is a tool that allows to detect the alterations of the microcirculation and to carry out the follow-up of the patients with low cost, non-invasiveness, repeatability, high sensibility and specificity.

Capillaroscopic Evidence of Microvascular Damage in Volleyball Players

Volleyball players experience repetitive stress that involves their hands and, in particular, their fingers. Literature reports that repetitive trauma can lead to local vascular abnormalities, such as reduced capillarization and lower resting blood flow. These anomalies could be related to the presence of dysfunctional endothelium. The aim of this study is to correlate the capillaroscopic findings by nailfold video capillaroscopy (NVC) to volleyball practice in order to early detect possible anomalies and perform an adequate follow-up to avoid damages that could negatively affect sport practice and the players' health status. In this study, 38 subjects were enrolled, 19 volleyball players and 19 healthy non-players as a comparison group. In almost all the players, we found capillaroscopic alterations of the "aspecific pattern" type without substantial gender differences. We may assume that the repeated traumas involving players' fingers can negatively modify their microcirculation. Based on these observations, it could be a desirable clinical practice to screen professional volleyball players with NVC in order to implement preventive strategies aimed at protecting the health of athletes.

Peripheral Vascular Abnormalities in Anorexia Nervosa: A Psycho-Neuro-Immune-Metabolic Connection

Immune, neuroendocrine, and autonomic nervous system dysregulation in anorexia nervosa lead to cardiovascular complications that can potentially result in increased morbidity and mortality. It is suggested that a complex non-invasive assessment of cardiovascular autonomic regulation-cardiac vagal control, sympathetic vascular activity, and cardiovascular reflex control-could represent a promising tool for early diagnosis, personalized therapy, and monitoring of therapeutic interventions in anorexia nervosa particularly at a vulnerable adolescent age. In this view, we recommend to consider in the diagnostic route, at least in the subset of patients with peripheral microvascular symptoms, a nailfold video-capillaroscopy as an easy not invasive tool for the early assessing of possible cardiovascular involvement.

Microvascular Damage in a Young Female Archer Assessed by Nailfold Videocapillaroscopy: A Case Report

Archers are known to be exposed to the risk of developing various injuries, including less described microvascular damages, which can however heavily affect the performance of athletes. Nailfold videocapillaroscopy is a safe, proven and non-invasive method that allows us to examine the nail capillaries and diagnose vascular anomalies in athletes suffering from the consequences of microtrauma caused by repeated use of fingertips. The detection of defined capillaroscopic pictures is the basis for the follow-up and suggests carrying out further clinical investigations to exclude underlying pathologies. In women this aspect is even more important since they are more frequently affected by autoimmune diseases such as scleroderma which can cause microcirculation alterations. We report the case of a 16-year-old woman who has been practicing archery for five years. She had been complaining for two years about painful fingertips, worsening in the last year. Through videocapillaroscopy, carried out by using a ×200 optical probe-equipped videocapillaroscope connected to image analyzer software (VideoCap software 3.0; DS Medica, Milan, Italy), we detected changes in the microvasculature compatible with a non-specific pattern. The findings of these anomalies suggest a diagnostic analysis aimed at excluding the presence of systemic diseases such as scleroderma. Once these conditions are excluded, and assuming that the documented alterations are due to the particular muscular effort and vibrations to which the fingers are subjected in shooting, we suggest follow-up to keep under control possible further developments and clinical changes. As far as we know, this is the first report that documents and describes the condition of microvascular changes in an archer. Archers, similar to other athletes who mainly use fingertips such as volleyball players, are more exposed to the development of digital traumas that can induce alterations in the microcirculation. We suggest that a periodic capillaroscopy should be included in the health surveillance program of these athletes, in fact this simple, reliable, non-invasive and inexpensive diagnostic tool is able to recognize early signs of microvascular damage and then suggest indications for further investigations and or follow-up.