Nailfold capillaroscopy images

New project aims to bring earlier diagnosis for rare condition

A major new research project aims to help patients through earlier diagnosis of a rare, disabling condition.

Systemic sclerosis (also known as scleroderma) is a chronic disease of the immune system, blood vessels and connective tissue, which affects around 10,000 people in the UK.

It is an autoimmune condition, meaning the immune system becomes overactive and attacks healthy tissue in the body, causing scarring and stopping the affected parts of the body from functioning normally.

Early diagnosis and starting treatment promptly can help prevent painful finger ulcers, possible finger/toe amputation and life-threatening damage to internal organs.

Professor Ariane Herrick

The National Institute for Health Research (NIHR) has awarded more than £560,000 to fund Professors Chris Taylor and Ariane Herrick’s work on automated analysis of images of small blood vessels in the fingers for diagnosing systemic sclerosis.

Prof Taylor is Professor of Medical Biophysics and Computer Science at The University of Manchester and Prof Herrick is Professor of Rheumatology at the university and Consultant Rheumatologist at Salford Royal NHS Foundation Trust.

Their latest study is the culmination of more than 10 years of collaboration on automated image analysis to improve diagnosis of the condition.

Nailfold capillaroscopy allows the small blood vessels (capillaries) of the finger nailfold to be examined directly and non-invasively. These blood vessels are almost always abnormal in people with systemic sclerosis.


However, deciding whether these blood vessels are normal or abnormal can be very subjective, relying heavily on the opinion of the clinician examining them.

Professor Herrick said: “Currently systemic sclerosis is often diagnosed when it is fairly advanced, even though most patients will have noticed symptoms earlier. It’s a very disabling condition, and is often painful and disfiguring resulting in considerable distress so earlier diagnosis and starting treatment promptly is absolutely key.”

Professor Taylor added: “We plan to bring early diagnosis to the general rheumatology clinic by developing a system to detect changes in the capillaries at the base of the fingernails, caused by the disease, automatically, using images obtained using a simple hand-held USB microscope.”

The study will involve examining  the nailfold capillaries of 200 patients and healthy controls using different types of capillaroscopy equipment, and  will be running over the next two and a half years.  Others involved in the project are Professor Andy Vail, Professor of Biostatistics, Professor Katherine Payne, Professor of Health Economics and Dr Andrea Murray, Senior Research Fellow.

  • The picture (top) shows nailfold videocapillaroscopy images from (A) healthy control, and (B) patient with systemic sclerosis, clearly showing the structural abnormalities present in systemic sclerosis. Equivalent images taken with an inexpensive low-magnification system are shown for (C) healthy control and (D) patient with systemic sclerosis.
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