How to perform and interpret capillaroscopy

• Published in: Best practice & research. Clinical rheumatology 2013-04, Vol.27 (2), p.237-248
• Main Authors: Cutolo, Maurizio, MD, Sulli, Alberto, MD, Smith, Vanessa, MD, PhD
• Format: Article
• Language: English
• Subjects: Capillaries - pathology; Capillaroscopy; Connective tissue diseases; Humans; Imaging; Microscopic Angioscopy - methods; Nails - blood supply; Raynaud Disease - diagnosis; Raynaud's phenomenon; Rheumatology; Scleroderma patterns; Scleroderma, Systemic - diagnosis; Systemic sclerosis
• ISSN: 1521-6942; 1532-1770
• DOI: 10.1016/j.berh.2013.03.001

Abstract The essence of capillaroscopy is to examine, noninvasively and safely the morphology of nailfold dermal papillary capillaries using a magnification system (microscopical lenses). Capillaroscopy may be performed with lenses with low (×20) and with high magnification (×200 up to ×600). The video-capillaroscope consists of an optical/digital probe which is moved to the finger of the patient and allows direct contact with the nailfold. Through qualitative assessment a normal capillaroscopy can be distinguished from a pathognomonic abnormal one due most frequently to systemic sclerosis (SSc). This pattern recognition relies on evaluating the morphology of the capillaries, their density (number) and dimensions ‘at sight’ of the capillaries and their architecture. In SSc three progressive capillaroscopic patterns have been described (‘early’, ‘active’ and ‘late’). Quantitative assessment (quantitation of certain characteristics and semi-quantitative scoring) of the capillaroscopic pictures may also be performed. Qualitative and semi-quantitative assessments are used to predict SSc clinical complications. In other connective tissue diseases (CTDs) prospective clinical studies resulting in indices which can predict future clinical complications have not been published, as yet.