Skip to main content

Advertisement

Log in

Capillaroscopy: questions and answers

  • Review Article
  • Published:
Clinical Rheumatology Aims and scope Submit manuscript

Abstract

Capillaroscopy is an essential imaging technique used in the study of microcirculation and one of the best diagnostic tools for the early detection of systemic sclerosis and related conditions. However, despite the increasing interest in capillary microscopy, there is still a surprising discrepancy between its potential application and its still limited use in rheumatological practice. This contrast is really surprising because few diagnostic techniques can combine all the positive features typical of capillaroscopy (low cost, uninvasiveness, repeatability, high sensitivity, good specificity, easy interpretation of results). The lack of guidelines and recommendations concerning the right way to carry out a correct capillaroscopic examination and the interpretation of the most relevant capillaroscopic abnormalities may represent one of the major drawbacks for its widespread use. Discussion about controversies on this topic should be encouraged, leading to a progressive development of capillaroscopy as a routine investigation in rheumatology.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Maricq HR (1981) Wide-field capillary microscopy. Arthritis Rheum 24:1159–1165

    Article  CAS  PubMed  Google Scholar 

  2. Houtman PM, Kallenberg CGM, Fidler V et al (1986) Diagnostic significance of nailfold capillary patterns in patients with Raynaud’s phenomenon. J Rheumatol 13:556–563

    CAS  PubMed  Google Scholar 

  3. Statham BN, Rowell NR (1986) Quantification of the nailfold capillary abnormalities in systemic sclerosis and Raynaud’s phenomenon. Acta Derm Venereol 66:139–143

    CAS  PubMed  Google Scholar 

  4. Carpentier PH, Maricq HR (1990) Microvasculature in systemic sclerosis. Rheum Dis Clin North Am 16:75–91

    CAS  PubMed  Google Scholar 

  5. Wong ML, Highton J, Palmer DG (1988) Sequential nailfold capillary microscopy in scleroderma and related disorders. Ann Rheum Dis 47:53–61

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Lefford F, Edwards JCW (1986) Nailfold capillary microscopy in connective tissue disease: a quantitative morphological analysis. Ann Rheum Dis 45:741–749

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Scheja A, Akesson A, Niewierowicz I et al (1996) Computer based quantitative analysis of capillary abnormalities in systemic sclerosis and its relation to plasma concentration of von Willebrand factor. Ann Rheum Dis 55:52–56

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Chen ZY, Silver RM, Ainsworth SK et al (1984) Association between fluorescent antinuclear antibodies, capillary patterns, and clinical features in scleroderma spectrum disorders. Am J Med 77:812–822

    Article  CAS  PubMed  Google Scholar 

  9. Lovy M, MacCarter D, Steigerwald JC (1985) Relationship between nailfold capillary abnormalities and organ involvement in systemic sclerosis. Arthritis Rheum 28:496–501

    Article  CAS  PubMed  Google Scholar 

  10. Schmidt KU, Mensing H (1988) Are nailfold capillary changes indicators of organ involvement in progressive systemic sclerosis? Dermatologica 176:18–21

    Article  CAS  PubMed  Google Scholar 

  11. Cutolo M, Sulli A, Pizzorni C et al (2000) Nailfold videocapillaroscopy assessment of microvascular damage in systemic sclerosis. J Rheumatol 27:155–160

    CAS  PubMed  Google Scholar 

  12. Grassi W, Core P, Cervini C (1996) Increased capillary permeability in systemic sclerosis: help or hindrance? Ann Rheum Dis 55:603–606

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. LeRoy EC, Medsger TA Jr (1992) Raynaud’s phenomenon: a proposal for classification. Clin Exp Rheumatol 10:485–488

    CAS  PubMed  Google Scholar 

  14. Cutolo M, Grassi W, Matucci Cerinic M (2003) Raynaud’s phenomenon and the role of capillaroscopy. Arthritis Rheum 48:3023–3030

    Article  PubMed  Google Scholar 

  15. Grassi W, Del Medico P, Izzo F et al (2001) Microvascular involvement in systemic sclerosis: capillaroscopic findings. Semin Arthritis Rheum 30:397–402

    Article  CAS  PubMed  Google Scholar 

  16. Anders HJ, Sigl T, Schattenkirchner N (2001) Differentiation between primary and secondary Raynaud’s phenomenon: a prospective study comparing nailfold capillaroscopy using an ophtalmoscope or stereomicroscope. Ann Rheum Dis 60:407–409

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Bergman R, Sharony L, Schapira D et al (2003) The handheld dermatoscope as a nailfold capillaroscopic instrument. Arch Dermatol 139:1027–1030

    Article  PubMed  Google Scholar 

  18. Tektonidou M, Kaskani E, Skopouli FN et al (1999) Microvascular abnormalities in Sjögren’s syndrome: nailfold capillaroscopy. Rheumatology 38:826–830

    Article  CAS  PubMed  Google Scholar 

  19. Rozboril MB, Maricq HR, Rodnan GP et al (1983) Capillary microscopy in eosinophilic fasciitis. A comparison with systemic sclerosis. Arthritis Rheum 26:617–622

    Article  CAS  PubMed  Google Scholar 

  20. Zaric D, Worm AM, Stahl D et al (1981) Capillary microscopy of the nailfold in psoriatic and rheumatoid arthritis. Scand J Rheumatol 10:249–252

    Article  CAS  PubMed  Google Scholar 

  21. Grassi W, Core P, Carlino G et al (1992) Nailfold capillary permeability in psoriatic arthritis. Scand J Rheumatol 21:226–230

    Article  CAS  PubMed  Google Scholar 

  22. Dinc A, Melikoglu M, Korkmaz C et al (2001) Nailfold capillary abnormalities in patients with familial Mediterranean fever. Clin Exp Rheumatol 19(Suppl 24):S42–S44

    CAS  PubMed  Google Scholar 

  23. Vaiopoulos G, Pangratis N, Samarkos M et al (1995) Nailfold capillary abnormalities in Behçet’s disease. J Rheumatol 22:1108–1111

    CAS  PubMed  Google Scholar 

  24. Sulli A, Pizzorni C, Cutolo M (2000) Nailfold videocapillaroscopy in patients with antiphospholipid antibodies. J Rheumatol 27:1574–1576

    CAS  PubMed  Google Scholar 

  25. Grassi W, Core P, Carlino G et al (1994) Capillary permeability in fibromyalgia. J Rheumatol 21:1328–1331

    CAS  PubMed  Google Scholar 

  26. Fahrig C, Heidrich H, Voigt B et al (1995) Capillary microscopy of the nailfold in healthy subjects. Int J Microcirc Clin Exp 15:287–292

    Article  CAS  PubMed  Google Scholar 

  27. Herrick AL, Moore T, Hollis S et al (2000) The influence of age on nailfold capillary dimensions in childhood. J Rheumatol 27:797–800

    CAS  PubMed  Google Scholar 

  28. Merlen JF (1985) Capillaroscopy at the nailbed in functioning people aged 70 and over. Int Angiol 4:285–288

    CAS  PubMed  Google Scholar 

  29. Michoud E, Poensin D, Carpentier PH (1994) Digitized nailfold capillaroscopy. Vasa 23:35–42

    CAS  PubMed  Google Scholar 

  30. Bukhari M, Hollis S, Moore T et al (2000) Quantitation of microcirculatory abnormalities in patients with primary Raynaud’s phenomenon and systemic sclerosis by video-capillaroscopy. Rheumatology 39:506–512

    Article  CAS  PubMed  Google Scholar 

  31. Anderson ME, Allen PD, Moore T et al (2005) Computerized nailfold videocapillaroscopy. A new tool for assessment of Raynaud’s phenomenon. J Rheumatol 32:841–848

    PubMed  Google Scholar 

  32. Leteurtre E, Hachulla E, Janin A et al (1994) Vascular manifestations of dermatomyositis and polymyositis: clinical, capillaroscopic and histological aspects. Rev Med Interne 15:800–807

    Article  CAS  PubMed  Google Scholar 

  33. De Angelis R, Bugatti L, Del Medico P et al (2002) Videocapillaroscopic findings in the microcirculation of the psoriatic plaque. Dermatology 204:236–239

    Article  PubMed  Google Scholar 

  34. Chang CH, Tsai RK, Wu WC et al (1997) Use of dynamic capillaroscopy for studying cutaneous microcirculation in patients with diabetes mellitus. Microvasc Res 53:121–127

    Article  CAS  PubMed  Google Scholar 

  35. Monticone G, Colonna L, Palermi G et al (2000) Quantitative nailfold capillary microscopy findings in patients with acrocyanosis compared with patients having systemic sclerosis. J Am Acad Dermatol 42:787–790

    Article  CAS  PubMed  Google Scholar 

  36. Fitzgerald O, C’Connor GT, Spencer-Green G (1988) Prospective study on the evolution of Raynaud’s phenomenon. Am J Med 84:718–726

    Article  CAS  PubMed  Google Scholar 

  37. Spencer-Green G (1998) Outcomes in primary Raynaud’s phenomenon. A meta-analysis of frequency, rates and predictors of transition to secondary disease. Arch Intern Med 158:595–600

    Article  CAS  PubMed  Google Scholar 

  38. Luggen M, Belhorn L, Evans T et al (1995) The evolution of Raynaud’s phenomenon: a longterm prospective study. J Rheumatol 22:2226–2232

    CAS  PubMed  Google Scholar 

  39. Maricq HR, Harper FE, Khan MM et al (1983) Microvascular abnormalities as possible predictors of disease subsets in Raynaud’s phenomenon and early connective tissue disease. Clin Exp Rheumatol 1:195–205

    CAS  PubMed  Google Scholar 

  40. ter Borg EJ, Piersma-Wichers G, Smit AJ et al (1994) Serial nailfold capillary microscopy in primary Raynaud’s phenomenon and scleroderma. Semin Arthritis Rheum 24:40–47

    Article  PubMed  Google Scholar 

  41. Bredemeier M, Xavier RM, Capobianco KG et al (2004) Nailfold capillary microscopy can suggest pulmonary disease activity in systemic sclerosis. J Rheumatol 31:286–294

    PubMed  Google Scholar 

  42. Kabasakal Y, Elvins DM, Ring EFJ et al (1996) Quantitative nailfold capillaroscopy findings in a population with connective tissue disease and in normal healthy controls. Ann Rheum Dis 55:507–512

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  43. Cutolo M, Pizzorni C, Tuccio M et al (2004) Nailfold videocapillaroscopic patterns and serum autoantibodies in systemic sclerosis. Rheumatology 43:719–726

    Article  CAS  PubMed  Google Scholar 

  44. Jayson MIV (1984) The microcirculation in systemic sclerosis. Clin Exp Rheumatol 2:85–91

    CAS  PubMed  Google Scholar 

  45. Wigley FM, Wise RA, Miller R et al (1992) Anticentromere antibody as a predictor of digital ischemic loss in patients with systemic sclerosis. Arthritis Rheum 35:688–693

    Article  CAS  PubMed  Google Scholar 

  46. Grassi W, Core P, Carlino G et al (1994) Effects of peripheral cold exposure on microvascular dynamics in systemic sclerosis. Arthritis Rheum 37:384–390

    Article  CAS  PubMed  Google Scholar 

  47. Filaci G, Cutolo M, Scudeletti M et al (1999) Cyclosporin A and iloprost treatment of systemic sclerosis: clinical results and interleukin-6 serum changes after 12 months of therapy. Rheumatology 38:992–996

    Article  CAS  PubMed  Google Scholar 

  48. Faggioli P, Giani L, Mazzone A (2006) Possibile role of iloprost (stable analogue of PGI2) in promoting neoangiogenesis in systemic sclerosis. Clin Exp Rheumatol 24:220

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Rossella De Angelis.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Grassi, W., De Angelis, R. Capillaroscopy: questions and answers. Clin Rheumatol 26, 2009–2016 (2007). https://doi.org/10.1007/s10067-007-0681-3

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10067-007-0681-3

Keywords

Navigation