Nigro Angelo
Department of Rheumatology of Lucania - UOSD of Rheumatology, "Madonna delle Grazie" Hospital, Matera, Italy.
Mediterr J Rheumatol. 2025 Jun 30;36(2):339-342. doi: 10.31138/mjr.280225.era. eCollection 2025 Jun.
We report the case of a 50-year-old female smoker presenting with isolated algodystrophy of the navicular bone and concurrent nailfold videocapillaroscopy (NVC) abnormalities. This observation raises the possibility of an association between microvascular alterations and the etiopathogenesis of algodystrophy. NVC revealed enlarged loops, tortuosity, pericapillary oedema, and microhaemorrhages, findings indicative of impaired microcirculation. Magnetic resonance imaging (MRI) of the foot demonstrated bone marrow oedema consistent with algodystrophy. The patient underwent intramuscular treatment with neridronate, which resulted in full symptomatic remission and radiological resolution at three months. This case highlights the potential role of microvascular dysfunction in algodystrophy and suggests that NVC may serve as a valuable diagnostic tool in patients with unexplained regional pain syndromes. Future studies are required to establish a definitive causal relationship.
我们报告了一例50岁女性吸烟者，其表现为舟骨孤立性痛性营养不良，并伴有甲襞微血管镜检查（NVC）异常。这一观察结果提示微血管改变与痛性营养不良的病因学之间可能存在关联。NVC显示血管襻增大、迂曲、毛细血管周围水肿和微出血，这些表现提示微循环受损。足部磁共振成像（MRI）显示骨髓水肿，与痛性营养不良相符。该患者接受了奈立膦酸肌肉注射治疗，三个月后症状完全缓解，影像学表现恢复正常。本病例突出了微血管功能障碍在痛性营养不良中的潜在作用，并表明NVC可能是不明原因区域性疼痛综合征患者的一种有价值的诊断工具。需要进一步的研究来确定明确的因果关系。
