Absence of Scleroderma pattern at nail fold capillaroscopy valuable in the exclusion of Scleroderma in unselected patients with Raynaud's Phenomenon

To report the predictive value of nail-fold capillaroscopy (NFC) patterns of vasculopathy for systemic sclerosis (Scleroderma; SSc) in an unselected cohort of patients with Raynaud's phenomenon (RP). Patients referred to a tertiary SSc clinic with RP were evaluated by light/video-NFC. Clinical...

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Bibliographic Details
Published in:BMC musculoskeletal disorders 2016-08, Vol.17 (1), p.342-342, Article 342
Main Authors: Bissell, Lesley-Anne, Abignano, Giuseppina, Emery, Paul, Del Galdo, Francesco, Buch, Maya H
Format: Article
Language:English
Subjects:
Adult
Aged
Antibodies
Care and treatment
Clinical trials
Diagnosis
Female
Humans
Male
Microscopic Angioscopy
Middle Aged
Nails - diagnostic imaging
Patient Selection
Physiological aspects
Predictive Value of Tests
Raynaud Disease - diagnostic imaging
Retrospective Studies
Risk factors
Scleroderma (Disease)
Scleroderma, Systemic - diagnostic imaging
Sensitivity and Specificity
Systemic scleroderma
Viral antibodies
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Summary:To report the predictive value of nail-fold capillaroscopy (NFC) patterns of vasculopathy for systemic sclerosis (Scleroderma; SSc) in an unselected cohort of patients with Raynaud's phenomenon (RP). Patients referred to a tertiary SSc clinic with RP were evaluated by light/video-NFC. Clinical diagnosis, details and serology were recorded. Primary RP was defined as RP with no features of connective tissue disease (CTD)/antibody. NFC patterns were determined: normal, non-specific, 'early', 'active' or 'late' SSc patterns. Fulfilment of the VEDOSS or 2013 ACR/EULAR criteria for SSc was determined following NFC assessment. Three hundred forty-seven patients were referred: mean (SD) age 47 (15.2) years. On clinical review, 54 (16 %) did not have RP, 69 (20 %) had primary RP, 52 (15 %) had SSc and 172 (50 %) had secondary RP. NFC SSc pattern was detected in 80 (23 %) patients; 37/52 with SSc, 30/172 with secondary RP, 9/69 with primary RP and 4/54 with no RP. For identifying patients who met either the VEDOSS or 2013 ACR/EULAR criteria for SSc, detection of a SSc NFC pattern had a sensitivity of 71 %, specificity 95 %, positive predictive value 84 % and negative predictive value 90 %. The absence of SSc NFC pattern in patients with RP or suspected CTD is very valuable in the exclusion of SSc.
ISSN:1471-2474
1471-2474
DOI:10.1186/s12891-016-1206-5