Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Feb;48(2):247-250.
doi: 10.3899/jrheum.191371. Epub 2020 Jun 15.

Raynaud Phenomenon in Systemic Sclerosis: Does Digital Thermal Monitoring Correlate to Specific Nailfold Videocapillaroscopy Abnormalities?

Julie K Thomas  1 , Mislav Radic  2 , Jordan R Tucker  3 , Rebecca Overbury  4 , Tracy M Frech  5
Affiliations

Raynaud Phenomenon in Systemic Sclerosis: Does Digital Thermal Monitoring Correlate to Specific Nailfold Videocapillaroscopy Abnormalities?

Julie K Thomas et al. J Rheumatol. 2021 Feb.

Abstract

Objective: Early diagnosis of systemic sclerosis (SSc) is imperative, and Raynaud phenomenon (RP) is an important component of progressive vasculopathy. Nailfold videocapillaroscopy (NVC) is a well-established tool that can quantify structural vascular abnormalities. Digital thermal monitoring (DTM) assesses microvascular functional dysfunction related to thermoregulation. In this study, we investigated the correlation of NVC patterns and DTM variables in patients with SSc.

Methods: Patients with SSc according to the 2013 American College of Rheumatology/European League Against Rheumatism criteria who consented and enrolled in the clinical care registry had NVC and DTM performed. For NVC, the number of capillaries (density), measurement of apical diameter (dimension), presence or absence of hemorrhages, and number of abnormal shapes were assessed to categorize 3 different qualitative patterns: early, active, and late. For DTM, Doppler ultrasound hyperemic, low frequency, blood velocity of radial artery, and fingertip vascular function were assessed, and a vascular reactivity index (VRI) measurement was automated. Statistical evaluation was performed by nonparametric tests to assess the correlation of NVC and VRI.

Results: Thirty-one SSc subjects with interpretable NVC and DTM performed on the same day were included in the study. VRI was progressively higher in SSc patients with early, active, and late NVC patterns of microangiopathy (P < 0.0001). There was a significant negative correlation between VRI and microhemorrhages scores (r = -0.363, P = 0.044).

Conclusion: Our study suggests that more advanced vasculopathy correlates to reduced microvascular function as detected by DTM and more advanced structural abnormalities detected by NVC. NVC and DTM may provide different aspects of vasculopathy quantification and complement each other as investigative tools.

Keywords: Raynaud phenomenon; capillaries; systemic sclerosis.

PubMed Disclaimer

Conflict of interest statement

Disclosures: The authors have no conflict of interest to disclose.

Figures

Figure 1:
Figure 1:
Digital Thermal Monitoring Report from Participant
Figure 2:
Figure 2:
NVC findings from Participant
See this image and copyright information in PMC

References

    1. Wigley FM, Flavahan NA. Raynaud’s Phenomenon. N Engl J Med. 2016;375(6):556–65. - PubMed
    1. Guiducci S, Bellando-Randone S, Matucci-Cerinic M. A New Way of Thinking about Systemic Sclerosis: The Opportunity for a Very Early Diagnosis. Isr Med Assoc J 2016;18(3–4):141–3. - PubMed
    1. Hughes M, Herrick AL. Digital ulcers in systemic sclerosis. Rheumatology (Oxford). 2017;56(1):14–25. - PubMed
    1. Frech TM, Machin DR, Murtaugh MA, Stoddard GJ, Bloom SI, Phibbs JV, et al. Implications of endothelial shear stress on systemic sclerosis vasculopathy and treatment. Clin Exp Rheumatol. 2018;36 Suppl 113(4):175–82. - PMC - PubMed
    1. Flavahan NA. A vascular mechanistic approach to understanding Raynaud phenomenon. Nat Rev Rheumatol. 2015;11(3):146–58. - PubMed

Publication types

MeSH terms