Thermographic Abnormalities are Associated with Future Digital Ulcers and Death in Patients with Systemic Sclerosis.
Capillaroscopic abnormalities are predictive of future digital ulcers (DU). Our aim was to investigate whether functional digital vascular disease (thermographically assessed) is also associated with future DU.



A retrospective case note review of patients with systemic sclerosis (SSc) undergoing thermography and who were followed for up to about 3 years.



There were 138 patients (equal mixture of normal/abnormal thermography). Patients with abnormal thermography were more likely to develop DU (clinician-observed and/or patient-reported, OR 2.84, p = 0.021), including multiple episodes, and more likely to die (OR 5.42, p = 0.050).



Abnormal thermography is associated with DU and disease severity in patients with SSc.
From the Centre for Musculoskeletal Research, University of Manchester, Manchester Academic Health Science Centre; Photon Science Institute, University of Manchester; UK National Institute for Health Research (NIHR) Manchester Musculoskeletal Biomedical Research Unit, Central Manchester National Health Service (NHS) Foundation Trust, Manchester Academic Health Science Centre, Manchester; Research and Development, and Department of Rheumatology, Salford Royal NHS Foundation Trust, Salford, UK.M. Hughes, MSc, MRCP, Centre for Musculoskeletal Research, University of Manchester, Manchester Academic Health Science Centre; J. Wilkinson, MSc, Research and Development, Salford Royal NHS Foundation Trust; T. Moore, BSc, Department of Rheumatology, Salford Royal NHS Foundation Trust; J. Manning, BSc, Department of Rheumatology, Salford Royal NHS Foundation Trust; P. New, MPharm, Department of Rheumatology, Salford Royal NHS Foundation Trust; G. Dinsdale, PhD, Centre for Musculoskeletal Research, University of Manchester, Manchester Academic Health Science Centre; A. Murray, PhD, Centre for Musculoskeletal Research, University of Manchester, Manchester Academic Health Science Centre, and Photon Science Institute, University of Manchester; A.L. Herrick, MD, FRCP, Centre for Musculoskeletal Research, University of Manchester, Manchester Academic Health Science Centre, and NIHR Manchester Musculoskeletal Biomedical Research Unit, Central Manchester NHS Foundation Trust, Manchester Academic Health Science Centre. Michael.Hughes-6@postgrad.manchester.ac.uk.
Michael
M
Hughes
From the Centre for Musculoskeletal Research, University of Manchester, Manchester Academic Health Science Centre; Photon Science Institute, University of Manchester; UK National Institute for Health Research (NIHR) Manchester Musculoskeletal Biomedical Research Unit, Central Manchester National Health Service (NHS) Foundation Trust, Manchester Academic Health Science Centre, Manchester; Research and Development, and Department of Rheumatology, Salford Royal NHS Foundation Trust, Salford, UK.M. Hughes, MSc, MRCP, Centre for Musculoskeletal Research, University of Manchester, Manchester Academic Health Science Centre; J. Wilkinson, MSc, Research and Development, Salford Royal NHS Foundation Trust; T. Moore, BSc, Department of Rheumatology, Salford Royal NHS Foundation Trust; J. Manning, BSc, Department of Rheumatology, Salford Royal NHS Foundation Trust; P. New, MPharm, Department of Rheumatology, Salford Royal NHS Foundation Trust; G. Dinsdale, PhD, Centre for Musculoskeletal Research, University of Manchester, Manchester Academic Health Science Centre; A. Murray, PhD, Centre for Musculoskeletal Research, University of Manchester, Manchester Academic Health Science Centre, and Photon Science Institute, University of Manchester; A.L. Herrick, MD, FRCP, Centre for Musculoskeletal Research, University of Manchester, Manchester Academic Health Science Centre, and NIHR Manchester Musculoskeletal Biomedical Research Unit, Central Manchester NHS Foundation Trust, Manchester Academic Health Science Centre.
Jack
J
Wilkinson
From the Centre for Musculoskeletal Research, University of Manchester, Manchester Academic Health Science Centre; Photon Science Institute, University of Manchester; UK National Institute for Health Research (NIHR) Manchester Musculoskeletal Biomedical Research Unit, Central Manchester National Health Service (NHS) Foundation Trust, Manchester Academic Health Science Centre, Manchester; Research and Development, and Department of Rheumatology, Salford Royal NHS Foundation Trust, Salford, UK.M. Hughes, MSc, MRCP, Centre for Musculoskeletal Research, University of Manchester, Manchester Academic Health Science Centre; J. Wilkinson, MSc, Research and Development, Salford Royal NHS Foundation Trust; T. Moore, BSc, Department of Rheumatology, Salford Royal NHS Foundation Trust; J. Manning, BSc, Department of Rheumatology, Salford Royal NHS Foundation Trust; P. New, MPharm, Department of Rheumatology, Salford Royal NHS Foundation Trust; G. Dinsdale, PhD, Centre for Musculoskeletal Research, University of Manchester, Manchester Academic Health Science Centre; A. Murray, PhD, Centre for Musculoskeletal Research, University of Manchester, Manchester Academic Health Science Centre, and Photon Science Institute, University of Manchester; A.L. Herrick, MD, FRCP, Centre for Musculoskeletal Research, University of Manchester, Manchester Academic Health Science Centre, and NIHR Manchester Musculoskeletal Biomedical Research Unit, Central Manchester NHS Foundation Trust, Manchester Academic Health Science Centre.
Tonia
T
Moore
From the Centre for Musculoskeletal Research, University of Manchester, Manchester Academic Health Science Centre; Photon Science Institute, University of Manchester; UK National Institute for Health Research (NIHR) Manchester Musculoskeletal Biomedical Research Unit, Central Manchester National Health Service (NHS) Foundation Trust, Manchester Academic Health Science Centre, Manchester; Research and Development, and Department of Rheumatology, Salford Royal NHS Foundation Trust, Salford, UK.M. Hughes, MSc, MRCP, Centre for Musculoskeletal Research, University of Manchester, Manchester Academic Health Science Centre; J. Wilkinson, MSc, Research and Development, Salford Royal NHS Foundation Trust; T. Moore, BSc, Department of Rheumatology, Salford Royal NHS Foundation Trust; J. Manning, BSc, Department of Rheumatology, Salford Royal NHS Foundation Trust; P. New, MPharm, Department of Rheumatology, Salford Royal NHS Foundation Trust; G. Dinsdale, PhD, Centre for Musculoskeletal Research, University of Manchester, Manchester Academic Health Science Centre; A. Murray, PhD, Centre for Musculoskeletal Research, University of Manchester, Manchester Academic Health Science Centre, and Photon Science Institute, University of Manchester; A.L. Herrick, MD, FRCP, Centre for Musculoskeletal Research, University of Manchester, Manchester Academic Health Science Centre, and NIHR Manchester Musculoskeletal Biomedical Research Unit, Central Manchester NHS Foundation Trust, Manchester Academic Health Science Centre.
Joanne
J
Manning
From the Centre for Musculoskeletal Research, University of Manchester, Manchester Academic Health Science Centre; Photon Science Institute, University of Manchester; UK National Institute for Health Research (NIHR) Manchester Musculoskeletal Biomedical Research Unit, Central Manchester National Health Service (NHS) Foundation Trust, Manchester Academic Health Science Centre, Manchester; Research and Development, and Department of Rheumatology, Salford Royal NHS Foundation Trust, Salford, UK.M. Hughes, MSc, MRCP, Centre for Musculoskeletal Research, University of Manchester, Manchester Academic Health Science Centre; J. Wilkinson, MSc, Research and Development, Salford Royal NHS Foundation Trust; T. Moore, BSc, Department of Rheumatology, Salford Royal NHS Foundation Trust; J. Manning, BSc, Department of Rheumatology, Salford Royal NHS Foundation Trust; P. New, MPharm, Department of Rheumatology, Salford Royal NHS Foundation Trust; G. Dinsdale, PhD, Centre for Musculoskeletal Research, University of Manchester, Manchester Academic Health Science Centre; A. Murray, PhD, Centre for Musculoskeletal Research, University of Manchester, Manchester Academic Health Science Centre, and Photon Science Institute, University of Manchester; A.L. Herrick, MD, FRCP, Centre for Musculoskeletal Research, University of Manchester, Manchester Academic Health Science Centre, and NIHR Manchester Musculoskeletal Biomedical Research Unit, Central Manchester NHS Foundation Trust, Manchester Academic Health Science Centre.
Paul
P
New
From the Centre for Musculoskeletal Research, University of Manchester, Manchester Academic Health Science Centre; Photon Science Institute, University of Manchester; UK National Institute for Health Research (NIHR) Manchester Musculoskeletal Biomedical Research Unit, Central Manchester National Health Service (NHS) Foundation Trust, Manchester Academic Health Science Centre, Manchester; Research and Development, and Department of Rheumatology, Salford Royal NHS Foundation Trust, Salford, UK.M. Hughes, MSc, MRCP, Centre for Musculoskeletal Research, University of Manchester, Manchester Academic Health Science Centre; J. Wilkinson, MSc, Research and Development, Salford Royal NHS Foundation Trust; T. Moore, BSc, Department of Rheumatology, Salford Royal NHS Foundation Trust; J. Manning, BSc, Department of Rheumatology, Salford Royal NHS Foundation Trust; P. New, MPharm, Department of Rheumatology, Salford Royal NHS Foundation Trust; G. Dinsdale, PhD, Centre for Musculoskeletal Research, University of Manchester, Manchester Academic Health Science Centre; A. Murray, PhD, Centre for Musculoskeletal Research, University of Manchester, Manchester Academic Health Science Centre, and Photon Science Institute, University of Manchester; A.L. Herrick, MD, FRCP, Centre for Musculoskeletal Research, University of Manchester, Manchester Academic Health Science Centre, and NIHR Manchester Musculoskeletal Biomedical Research Unit, Central Manchester NHS Foundation Trust, Manchester Academic Health Science Centre.
Graham
G
Dinsdale
From the Centre for Musculoskeletal Research, University of Manchester, Manchester Academic Health Science Centre; Photon Science Institute, University of Manchester; UK National Institute for Health Research (NIHR) Manchester Musculoskeletal Biomedical Research Unit, Central Manchester National Health Service (NHS) Foundation Trust, Manchester Academic Health Science Centre, Manchester; Research and Development, and Department of Rheumatology, Salford Royal NHS Foundation Trust, Salford, UK.M. Hughes, MSc, MRCP, Centre for Musculoskeletal Research, University of Manchester, Manchester Academic Health Science Centre; J. Wilkinson, MSc, Research and Development, Salford Royal NHS Foundation Trust; T. Moore, BSc, Department of Rheumatology, Salford Royal NHS Foundation Trust; J. Manning, BSc, Department of Rheumatology, Salford Royal NHS Foundation Trust; P. New, MPharm, Department of Rheumatology, Salford Royal NHS Foundation Trust; G. Dinsdale, PhD, Centre for Musculoskeletal Research, University of Manchester, Manchester Academic Health Science Centre; A. Murray, PhD, Centre for Musculoskeletal Research, University of Manchester, Manchester Academic Health Science Centre, and Photon Science Institute, University of Manchester; A.L. Herrick, MD, FRCP, Centre for Musculoskeletal Research, University of Manchester, Manchester Academic Health Science Centre, and NIHR Manchester Musculoskeletal Biomedical Research Unit, Central Manchester NHS Foundation Trust, Manchester Academic Health Science Centre.
Andrea
A
Murray
From the Centre for Musculoskeletal Research, University of Manchester, Manchester Academic Health Science Centre; Photon Science Institute, University of Manchester; UK National Institute for Health Research (NIHR) Manchester Musculoskeletal Biomedical Research Unit, Central Manchester National Health Service (NHS) Foundation Trust, Manchester Academic Health Science Centre, Manchester; Research and Development, and Department of Rheumatology, Salford Royal NHS Foundation Trust, Salford, UK.M. Hughes, MSc, MRCP, Centre for Musculoskeletal Research, University of Manchester, Manchester Academic Health Science Centre; J. Wilkinson, MSc, Research and Development, Salford Royal NHS Foundation Trust; T. Moore, BSc, Department of Rheumatology, Salford Royal NHS Foundation Trust; J. Manning, BSc, Department of Rheumatology, Salford Royal NHS Foundation Trust; P. New, MPharm, Department of Rheumatology, Salford Royal NHS Foundation Trust; G. Dinsdale, PhD, Centre for Musculoskeletal Research, University of Manchester, Manchester Academic Health Science Centre; A. Murray, PhD, Centre for Musculoskeletal Research, University of Manchester, Manchester Academic Health Science Centre, and Photon Science Institute, University of Manchester; A.L. Herrick, MD, FRCP, Centre for Musculoskeletal Research, University of Manchester, Manchester Academic Health Science Centre, and NIHR Manchester Musculoskeletal Biomedical Research Unit, Central Manchester NHS Foundation Trust, Manchester Academic Health Science Centre.
Ariane L
AL
Herrick
D000328:Adult; D000368:Aged; D005260:Female; D005385:Fingers / Q000098:blood supply* / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D020678:Microscopic Angioscopy; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D012595:Scleroderma, Systemic / Q000000981:diagnostic imaging* / Q000503:physiopathology; D012883:Skin Ulcer / Q000000981:diagnostic imaging* / Q000503:physiopathology; D013817:Thermography; D014652:Vascular Diseases / Q000000981:diagnostic imaging* / Q000503:physiopathology
DEATH; DIGITAL ULCERS; SCLERODERMA; SYSTEMIC SCLEROSIS; THERMOGRAPHY