Clinical Cases
Real-world case studies with capillaroscopic images, interpretation, and clinical correlation.
Case-Based Learning
Clinical cases demonstrate practical application of capillaroscopic interpretation in real-world scenarios. Each case card includes diagnosis-focused clinical context, structured capillaroscopy interpretation, and key findings designed for rapid review and searchability.
Cases are organized by diagnosis and pattern type, allowing targeted study of specific conditions and presentations. Interactive viewer datasets are progressively added as each case package is finalized.
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MPO-ANCA Vasculitis with Rapidly Progressive Glomerulonephritis
A 57-year-old man with newly diagnosed MPO-ANCA vasculitis and rapidly progressive glomerulonephritis.
Clinical context: The patient presented with renal failure and nephritic syndrome, and kidney biopsy confirmed rapidly progressive glomerulonephritis in the setting of MPO-ANCA vasculitis.
Capillaroscopy: Capillaroscopy shows mildly reduced density (7.0 capillaries/mm), frequent capillary dilations, microhemorrhages, and no giant capillaries, consistent with a non-specific microvascular pattern.
Key Capillaroscopic Findings:
- • Mild capillary density reduction (7.0/mm)
- • Frequent capillary dilations (58.2%)
- • Microhemorrhages (0.5/mm), without giant capillaries
Anti-Mi2β Dermatomyositis in Active Disease
A 32-year-old woman with active anti-Mi2β-positive dermatomyositis and marked microvascular damage on capillaroscopy.
Clinical context: After 3 months of progressive symptoms, diagnosis was established based on proximal muscle weakness, Gottron papules, heliotrope rash, and hyperCKemia (~2500).
Capillaroscopy: There is marked capillary loss (4.8/mm), architectural disorganization, frequent dilations, giant capillaries, and abnormal/branched shapes, indicating severe active microangiopathy.
Key Capillaroscopic Findings:
- • Severe capillary loss (4.8/mm)
- • Giant capillaries (8.8%) and frequent dilations (59.4%)
- • Abnormal/branched capillaries (32.1%) with vascular remodeling
Limited Cutaneous Systemic Sclerosis (ACA+) with Active Cutolo Pattern
A 38-year-old woman with limited cutaneous systemic sclerosis, anti-centromere antibodies, and established active microangiopathy.
Clinical context: This case includes a 5-year history of Raynaud's phenomenon, esophageal dysmotility, and interstitial lung disease with an NSIP pattern, without current indirect echocardiographic signs of pulmonary hypertension.
Capillaroscopy: Capillaroscopy shows marked capillary loss (5.3/mm), frequent dilations, high prevalence of giant capillaries (27.5%), and hemorrhages, matching an active Cutolo pattern.
Key Capillaroscopic Findings:
- • Marked capillary loss (5.3/mm)
- • High frequency of giant capillaries (27.5%)
- • Frequent capillary dilations (61.6%) with hemorrhages
Systematic Case Analysis
1. Clinical Context
Review patient demographics, symptoms, laboratory findings, and clinical examination.
2. Image Quality Assessment
Evaluate technical quality: focus, magnification, field of view, and proper nail fold selection.
3. Systematic Pattern Recognition
Identify capillary density, morphology, giant capillaries, hemorrhages, and avascular areas.
4. Pattern Classification
Classify as normal, non-specific abnormalities, or specific scleroderma pattern (early/active/late).
5. Clinical Correlation
Integrate capillaroscopic findings with clinical presentation for diagnostic synthesis.