Nailfold capillaroscopy: a survey of current UK practice and 'next steps' to increase uptake among rheumatologists. (28th May 2022)

• Record Type: Journal Article
• Authors: Eden, Martin; Wilkinson, Sarah; Murray, Andrea; Bharathi, Praveen Gurunath; Vail, Andy; Taylor, Chris J; Payne, Katherine; Herrick, Ariane L
• Is Part Of: Rheumatology. Volume 62:Number 1(2023)
• Page Start: 335
• Page End: 340
• Publication Date: 2022-05-28
• Subjects: nailfold capillaroscopy -- SSc -- Raynaud's phenomenon -- service evaluation; Rheumatism -- Periodicals; Rheumatology -- Periodicals; 616.723005
• DOI: 10.1093/rheumatology/keac320
• Languages: English
• ISSNs: 1462-0324

Abstract

Abstract: Objectives: To identify barriers to the use of nailfold capillaroscopy as a diagnostic tool for patients presenting with Raynaud's phenomenon in UK rheumatology centres and to obtain rheumatologists' views on a proposed internet-based standardized system for clinical reporting of nailfold capillaroscopy images. Methods: An online survey was developed using expert opinion from clinicians, scientists and health service researchers. The survey was piloted and sent to UK-based rheumatologists using established electronic mailing lists between October 2020 and March 2021. Survey data were analysed using descriptive statistics. Results: A total of 104 rheumatologists representing rheumatology centres across the UK responded to the survey. Wide variations in terms of workloads and practices were described. Thirty-four (33%) respondents reported using nailfold capillaroscopy only at their own centre, 33 (32%) referred to other centres, 9 (9%) did both and 28 (27%) did not use capillaroscopy at all. Of the 43 respondents using capillaroscopy on site, 25 (58%) used either a dermatoscope or universal serial bus microscope and 9 (21%) used videocapillaroscopy. Among the 61 respondents not undertaking capillaroscopy on site, barriers included lack of equipment (85%), lack of experience in acquiring images (69%) and lack of expertise in interpreting images (67%). Sixty-six respondents (63%) expressed interest in an internet-based, standardized automated system for reporting images. Conclusion: Most UK rheumatologists currently do not perform nailfold capillaroscopy on site. An internet-based nailfold capillaroscopy system for use with low-cost microscopes as well as with videocapillaroscopy could help increase uptake of capillaroscopy and thereby facilitate early diagnosis of SSc across the UK.