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Practical issues in assessing nailfold capillaroscopic images: a summary

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Abstract

Nailfold capillaroscopy (NC) is a highly sensitive, safe, and non-invasive technique to assess involvement rate of microvascularity in dermatomyositis and systemic sclerosis. A large number of studies have focused on NC pattern description, classification, and scoring system validation, but minimal information has been published on the accuracy and precision of the measurement. The objective of this review article is to identify different factors affecting the reliability and validity of the assessment in NC. Several factors can affect the reliability of the examination, e.g., physiological artifacts, the nailfold imaging instrument, human factors, and the assessment rules and standards. It is impossible to avoid all artifacts, e.g., skin transparency, physically injured fingers, and skin pigmentation. However, minimization of the impact of some of these artifacts by considering some protocols before the examination and by using specialized tools, training, guidelines, and software can help to reduce errors in the measurement and assessment of NC images. Establishing guidelines and instructions for automatic characterization and measurement based on machine learning techniques also may reduce ambiguities and the assessment time.

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Authors and Affiliations

  1. School of Engineering Sciences in Chemistry, Biotechnology and Health, KTH Royal Institute of Technology, Stockholm, Sweden

    Abdolamir Karbalaie & Björn-Erik Erlandsson

  2. Medical Image and Signal Processing Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

    Zahra Emrani

  3. Rheumatology Section, Department of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

    Alimohammad Fatemi

  4. Department of Medical Physics, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

    Mahnaz Etehadtavakol

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  1. Abdolamir Karbalaie
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Karbalaie, A., Emrani, Z., Fatemi, A. et al. Practical issues in assessing nailfold capillaroscopic images: a summary. Clin Rheumatol 38, 2343–2354 (2019). https://doi.org/10.1007/s10067-019-04644-9

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