Nailfold capillaroscopy: a survey of current UK practice and 'next steps' to increase uptake among rheumatologists

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish
Pages (from-to)335-340
Number of pages6
JournalRheumatology (Print)
Volume62
Issue number1
Early online date28 May 2022
DOIs
Publication statusPublished - 1 Jan 2023

Keywords

  • Humans
  • Microscopic Angioscopy/methods
  • Rheumatologists
  • Raynaud Disease/diagnosis
  • Surveys and Questionnaires
  • United Kingdom
  • Nails/diagnostic imaging
  • Capillaries
  • Scleroderma, Systemic

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