Isolated Navicular Algodystrophy and Abnormal Capillaroscopic Pattern in a 50-year-old Smoker: A Possible Microvascular Connection.

Abstract

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.