A nailfold capillaroscopy procedure is a non-invasive, low-cost, and well-established investigation that can be used to diagnose systemic sclerosis and other related conditions.

Nailfold capillaroscopy has seen a recent emergence as an application that can be used to diagnose connective tissue diseases. In addition, this investigative tool has been used to predict the activity of organ-specific complications, such as pulmonary hypertension, digital ulcers, and interstitial lung disease.

If you’re interested in learning the potential benefits that capillaroscopy has to offer to your patients, as well as your health practice, we’ve created an introduction to establishing the benefits and uses of this investigative tool. Keep reading to learn more!

What Is Nailfold Capillaroscopy?

Nailfold capillaroscopy is an investigative technique that allows medical professionals to visualize the nailfold capillaries.

The size of a capillary allows the body to pass a single red blood cell at one time, as capillaries are the smallest blood vessels available in the body. Capillaries are responsible for creating a complex network of U-shape structures that have a similar appearance to hairpins.

These capillaries allow the body to defuse gases and move substrates for non-essential byproducts of cellular respiration. Skin, which is the largest organ on the human body, has the largest network of capillaries. The capillaries that are involved with the skin are responsible for distributing blood from the arterioles to the surface of the skin, and sending it back down to the venous plexus.

At the extreme of a nailfold capillary, there is a loop that lies horizontally, which provides medical professionals with the ability to visualize the length of the capillary.

By identifying the loop that lies horizontally, medical professionals gain the ability to visualize the length of the capillary. Since there is no technology available to actually visualize capillaries by themselves, since the thin walls of capillaries are completely transparent, the red blood cell columns are what allow medical professionals to be able to identify nailfold capillaries.

As research on nailfold capillaries has continued, there have been studies that have proven that by identifying abnormalities in the structure of nailfold capillaries, certain diseases can be characterized by microvasculopathy.

The Role of Nailfold Capillaroscopy in a New Diagnosis

With an increase in interest in the advantages that nailfold capillaroscopy can bring to diagnosing diseases, there’s been a huge increase in the applications that can be used with this procedure.

While there has been plenty of research to establish the imperative role that nailfold capillaroscopy plays in the diagnosis of Systemic sclerosis, researchers and medical professionals have been able to show that capillaroscopy plays a role in diagnosing mixed connective tissue disease as well as idiopathic inflammatory myopathies.

There is still research being done to evaluate the potential role that capillaroscopy has to monitor and diagnose other health conditions such as Raynaud’s phenomenon.

During a nailfold capillaroscopy procedure, a medical professional will take a look at the variety of different functional and morphological changes in the capillaries. They’ll observe the visibility of the capillaries, the diameter, the morphology, the density, the distribution, and look for any microhemorrhages.

As discussed earlier, healthy capillaries have a similar display to a hairpin, with no hemorrhages, no ramifications, and should run parallel to the skin. Also, the density of the capillaries should be between 9 to 12 per mm.

If there is an identification of any abnormally large capillary vessel diameter, tortuous loop frequencies, or decreased capillary density, it’s a sign that signifies pathology. An identification of microhemorrhages has been the diagnostic tool for systemic sclerosis, especially if there’s also a pairing of mega capillaries identified.

Nailfold Capillaroscopy Procedure

For a nailfold capillaroscopy procedure to be completed, there are two essential elements. These elements are the acquisition of an image and interpreting the results of the image.

To reduce the chances of variability, you should perform the nailfold capillaroscopy in a warm environment. The majority of studies suggest allowing your patient a 15 to 30-minute window to acclimate to the temperature of the room that you’re performing the procedure in.

You should discuss with your patients to avoid drinking caffeine, taking any non-vital medications, and to avoid smoking before their procedure. Any of these abilities could create peripheral vasoconstriction right before the investigation.

To aid in being able to identify nailfold capillaries, you could apply an oil or gel to the patient nailfold in order to reduce the reflection on your patient’s skin that would be coming from the light source that you’re using on your capillaryscope.

The substances that are most commonly used during this procedure are lubricant jelly or a light olive oil that will be applied directly to the skin prior to the process of visualization.

Widefield Stereomicroscopy

This technique was the investigative instrument that was originally created for nailfold capillaroscopy. For this procedure to be completed, each nailfold was examined through a 20-fold magnification.

This provides a medical professional with a panoramic view of the complete nailfold. By using a microscope to view the depth of focus, you can combine a camera or another type of digital instrument to record images of your findings.

Widefield stereomicroscopy takes an estimated five minutes to complete.

Handheld Devices

In terms of handheld devices that you can use during a nailfold capillaroscopy procedure, ophthalmoscopes, dermatoscopes, and USB microscopes can be used.

Using handheld devices offers a unique advantage, doing the examination anywhere rather than having to bring a patient to a physical location to take the test. However, this advantage is only available at a minimal number of institutions. By using USB microscopes and attachments to smart devices, medical professionals will be able to achieve the same results as using lab approved equipment.

Nailfold Capillaroscopy AI

If you’re interested in speeding up the process by avoiding unnecessary and repetitive work, you can save time by skipping over the process to identify and locate capillaries manually.

This can be completed by using Capillary.io, which is a software that will go over the images of capillaries that you’ve taken to identify your findings. In addition, with Capillary.io, you can collaborate with other professionals to share the images that you’ve taken, and analyze your findings. You don’t need any type of special device to use capillary.io, as long as you have a microscope or a capillaryscope to take images of the capillaries.

With nailfold capillaroscopy AI, you can upload as many images as you choose to and organize them into folders. This AI technology has the ability to detect and classify your images, while also allowing you to view and edit the capillaries that were detected by the AI.

Plus, you won’t have to worry about sending your images via email (or keeping a USB hard drive with you). By using nailfold capillaroscopy AI technology, you can access your images on whatever online device you have.

By bringing nailfold capillaroscopy AI online, you’ll also gain the ability to collaborate with other medical professionals on the images that you choose. You can compare your findings to other images on our database and you can connect with other medical professionals to decide on medical findings.

In addition, you’ll have the ability to limit the activities of other users on your files. Once you’re ready to share your findings with your patients, you can easily download a report that contains both qualitative and quantitative information to share with your peers.

Understanding the Importance of Nailfold Capillaroscopy

This inexpensive, non-invasive procedure has established several roles in the diagnosis and the presence of several health conditions. In the upcoming years, there is expected to be an increase for nailfold capillaroscopy procedures as they become more reproducible, user-friendly, and understood by the medical community.

Are you interested in learning how your medical practice could benefit from the uses of Capillaroscopy AI? Click here to contact us today.