Department of Life, Health and Environmental Sciences, University of L'Aquila, 67100 L'Aquila, Italy.
Allergy and Clinical Immunology Unit, Center for the diagnosis and treatment of Osteoporosis, AUSL 04 Teramo, 64100 Teramo, Italy.
Int J Environ Res Public Health. 2020 Jun 12;17(12):4218. doi: 10.3390/ijerph17124218.
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.
弓箭手被认为有发生各种损伤的风险，包括较少描述的微血管损伤，但这些损伤可能会严重影响运动员的表现。甲襞毛细血管显微镜检查是一种安全、已证实且非侵入性的方法，它可以让我们检查指甲毛细血管，并诊断因反复使用指尖而导致微创伤的运动员的血管异常。发现特定的毛细血管图像是进行随访的基础，并提示进行进一步的临床检查以排除潜在的病理。对于女性来说，这方面更为重要，因为她们更容易受到自身免疫性疾病的影响，如硬皮病，这种疾病可能导致微循环改变。我们报告了一名 16 岁的女性病例，她从事射箭运动已有五年，两年来一直抱怨指尖疼痛，且在过去一年中恶化。通过使用配备 ×200 光学探头的视频显微镜（连接图像分析软件的 VideoCap 软件 3.0；DS Medica，米兰，意大利）进行视频毛细血管镜检查，我们发现了与非特异性模式相符的微血管变化。这些异常的发现提示进行诊断分析，以排除硬皮病等系统性疾病的存在。一旦排除这些情况，并假设所记录的改变是由于手指在射击时所承受的特殊肌肉用力和振动引起的，我们建议进行随访以控制可能的进一步发展和临床变化。据我们所知，这是第一份记录和描述射箭运动员微血管变化情况的报告。与其他主要使用指尖的运动员（如排球运动员）类似，弓箭手更容易发生手指创伤，这些创伤会导致微循环改变。我们建议将定期毛细血管镜检查纳入这些运动员的健康监测计划中，因为这种简单、可靠、非侵入性且廉价的诊断工具能够识别微血管损伤的早期迹象，然后为进一步的检查和/或随访提供建议。
