Evaluation of the microcirculation by the methods of Panoramic Nailfold Capillaroscopy and Videocapillaroscopy in patients with Systemic Sclerosis, and comparison of the diagnostic power and reproducibility between the two methods.
Nailfold Capillaroscopy (NC) is a noninvasive method that allows direct visualization of the microcirculation of the superficial distal row of capillaries of the nailfold region of the fingers of the hands. It is widely accepted for evaluation of morphological abnormalities and diagnostic investigation of Raynaud's phenomenon, Systemic Sclerosis (SSc) and related disorders. Structural changes in the microcirculation can be early detected by NC. Different equipments including the stereomicroscopy and videocapilaroscopie are used. In panoramic nailfold capillaroscopy the capillaries are classically evaluated using a stereomicroscopy, under 10-25 magnification. Videocapillaroscopy is a more recent method that uses very much higher magnification. There are no studies comparing the reproducibility and the diagnostic value for SSc between the two methods. In the present study, we will examine the reproducibility, sensitivity and specificity of different parameters evaluated by Panoramic Nailfold Capillaroscopy in comparison to Videocapillaroscopy in patients with systemic sclerosis. 50 healthy controls, 50 patients with Raynaud's phenomenon, and 100 patients with SSc, matched for sex and age will be studied. To assess the intraobserver reproducibility, twenty patients or controls will perform the two procedures on two different days with at least two weeks of interval between both evaluations. For assessment of reproducibility interobserver, twenty patients or controls will perform the two procedures with two different examiners. The Panoramic Nailfold Capillaroscopy view will be held using a stereomicroscope with magnification of 10 to 25 times. The Videocapillaroscopy will be performed under magnification of 200 times, with computerized equipment and the video system Videocap 8.14 (DS-Medica, Italy). The images will be stored in the videocapillaroscopy software and then analyzed under blinded conditions. The parameters measured will be compared for the reproducibility of the methods and for the sensitivity and specificity for diagnosis of SSc.
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