scholarly journals Nailfold Capillaroscopy in Rheumatic Diseases: Which Parameters Should Be Evaluated?

2015 ◽  
Vol 2015 ◽  
pp. 1-17 ◽  
Author(s):  
Mahnaz Etehad Tavakol ◽  
Alimohammad Fatemi ◽  
Abdolamir Karbalaie ◽  
Zahra Emrani ◽  
Björn-Erik Erlandsson
Keyword(s):  
Differential Diagnosis ◽  
Systemic Sclerosis ◽  
Early Diagnosis ◽  
Rheumatic Diseases ◽  
Raynaud’S Phenomenon ◽  
Nailfold Capillaroscopy ◽  
Classification Criterion ◽  
Clinical Practices ◽  
Main Indication ◽  
Monitoring Therapy

Video nailfold capillaroscopy (NFC), considered as an extension of the widefield technique, allows a more accurate measuring and storing of capillary data and a better defining, analyzing, and quantifying of capillary abnormalities. Capillaroscopic study is often performed on the patients suspected of having microcirculation problems such as Raynaud’s phenomenon as the main indication for nailfold capillaroscopy. Capillaroscopic findings based on microcirculation studies can provide useful information in the fields of pathophysiology, differential diagnosis, and monitoring therapy. Nailfold capillaroscopy provides a vital assessment in clinical practices and research; for example, its reputation in the early diagnosis of systemic sclerosis is well established and it is also used as a classification criterion in this regard. This review focuses on the manner of performing video nailfold capillaroscopy and on a common approach for measuring capillary dimensions in fingers and toes.

scholarly journals Nailfold Capillaroscopy in Rheumatic Diseases

2020 ◽  
Author(s):  
Abhishek Patil ◽  
Isha Sood
Keyword(s):  
Systemic Sclerosis ◽  
Connective Tissue ◽  
Early Diagnosis ◽  
Rheumatic Diseases ◽  
Connective Tissue Diseases ◽  
Nailfold Capillaroscopy ◽  
Indispensable Tool

Nailfold capillaroscopy (NFC) has developed into an indispensable tool for rheumatologists in the evaluation of rheumatic diseases. It offers various advantages in being rapid, noninvasive, and inexpensive. With NFC we are able to visualize the microcirculatory changes in the nail beds. These changes are key to the pathogenesis of connective tissue diseases such as systemic sclerosis. Hence NFC helps in early diagnosis of various connective tissue diseases. There is a lack of standardization in the techniques used and various capillary parameters studied, which could lead to variation in the reporting of the parameters studied. In this chapter we shall try to highlight the most common parameters studied in capillaroscopy and its utility in various connective tissue diseases.

T06.01.13 EARLY DIAGNOSIS OF SYSTEMIC SCLEROSIS IN PRIMARY BILIARY CHOLANGITIS: THE ROLE OF NAILFOLD CAPILLAROSCOPY

2020 ◽  
Vol 52 ◽  
pp. S163-S164
Author(s):  
D. Crescenzi ◽  
L. Maroni ◽  
M. Mazzetti ◽  
D. Menghini ◽  
C. Gelardi ◽  
...  
Keyword(s):  
Systemic Sclerosis ◽  
Early Diagnosis ◽  
Nailfold Capillaroscopy ◽  
Primary Biliary Cholangitis

scholarly journals Nailfold capillaroscopic findings in patients with Raynaud’s phenomenon: Preliminary report

2015 ◽  
Vol 4 (1) ◽  
pp. 13-15
Author(s):  
Binit Vaidya ◽  
Manisha Bhochhibhoya
Keyword(s):  
Rheumatoid Arthritis ◽  
Connective Tissue ◽  
Rheumatic Diseases ◽  
Morphological Changes ◽  
Raynaud’S Phenomenon ◽  
Raynaud's Phenomenon ◽  
Primary Diagnosis ◽  
Nailfold Capillaroscopy ◽  
Future Evolution ◽  
Non Invasive

Back grounds and Aims: Microvascular involvement of nailfold often occurs in systemic rheumatic diseases, especially scleroderma and related conditions. Nailfold capillaroscopy is easily performed non-invasive, simple, repeatable, sensitive, safe and inexpensive method to examine nailfold architecture by microscope.The normal capillaries are thin, symmetrical and have hair-pin appearance. Anomalies include dilated capillary loops, dropouts, tortuosity, avascular area, arborifications, megacapillaries, infracts,thrombsis and haemorrhages. This study aims to see the morphological changes in microcirculation in nailfolds of patients with Raynaud’s, which can be helpful in predicting the presence of connective tissue disorder.Methods: It is an observational study conducted at National Center for Rheumatic Diseases, Kathmandu from 26th March 2014 to 30th March 2015. Nailfolds of 8 fingers of both hands in 105 patients were examined using a hand held microscope.Results: Of 105 patients, 91 patients (86.6%) had abnormal morphological changes while 14 (13.4%) had no significant changes in microvessels. Normal patients had no underlying connective tissue disease(CTD) but those with abnormal findings had proven underlying CTD which included Lupus 6.5%, Scleroderma 17.5%, Rheumatoid Arthritis 14.2%, Mixed CTD7.6%, Undifferentiated CTD1.0%, Undifferentiated inflammatory arthritis 14.2%, Psorasis 1.0%, Rheumatoid Arthritis with scleroderma overlap 4.3%. No primary diagnosis was found in 32.9% of patients.Conclusion: Nailfold capillaroscopy allows direct examination of microvascular structure of a patient. Abnormal findings in a patient with Raynaud’s phenomenon might help to identify the presence of or future evolution into systemic connective tissue disorder.Journal of Advances in Internal Medicine 2015;04(01):13-15

scholarly journals The Place of Nailfold Capillaroscopy Among Instrumental Methods for Assessment of Some Peripheral Ischaemic Syndromes in Rheumatology

Folia Medica ◽  
2016 ◽  
Vol 58 (2) ◽  
pp. 77-88 ◽  
Author(s):  
Sevdalina N. Lambova
Keyword(s):  
Differential Diagnosis ◽  
Systemic Sclerosis ◽  
Doppler Ultrasound ◽  
Predictive Value ◽  
Laser Doppler ◽  
Nailfold Capillaroscopy ◽  
Doppler Imaging ◽  
Peripheral Arteries ◽  
Doppler Flowmetry ◽  
Instrumental Methods

AbstractMicro- and macrovascular pathology is a frequent finding in a number of common rheumatic diseases. Secondary Raynaud’s phenomenon (RP) is among the most common symptoms in systemic sclerosis and several other systemic autoimmune diseases including a broad differential diagnosis. It should be also differential from other peripheral vascular syndromes such as embolism, thrombosis, etc., some of which lead to clinical manifestation of the blue toe syndrome.The current review discusses the instrumental methods for vascular assessments.Nailfold capillaroscopy is the only method among the imaging techniques that can be used for morphological assessment of the nutritive capillaries in the nailfold area. Laser-Doppler flowmetry and laser-Doppler imaging are methods for functional assessment of microcirculation, while thermography and plethysmography reflect both blood flow in peripheral arteries and microcirculation. Doppler ultrasound and angiography visualize peripheral arteries. The choice of the appropriate instrumental method is guided by the clinical presentation. The main role of capillaroscopy is to provide differential diagnosis between primary and secondary RP. In rheumatology, capillaroscopic changes in systemic sclerosis have been recently defined as diagnostic. The appearance of abnormal capillaroscopic pattern inherits high positive predictive value for the development of a connective tissue disease that is higher than the predictive value of antinuclear antibodies. In cases of abrupt onset of peripheral ischaemia, clinical signs of critical ischaemia, unilateral or lower limb involvement, Doppler ultrasound and angiography are indicated. The most common causes for such clinical picture that may be referred to rheumatologic consultation are the antiphospholipid syndrome, mimickers of vasculitides such as atherosclerosis with cholesterol emboli, and neoplasms.

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