Nailfold capillaroscopic patterns in rheumatoid arthritis patients

Background: Rheumatoid arthritis (RA) is a chronic systemic inflammatory autoimmune disease. Nailfold  Capillaroscopy (NFC) is a rapid, low-cost, non-invasive diagnostic procedure for assessing  peripheral  microangiopathy in the early stages of RA.
Objective: to identify nailfold capillaroscopic patterns in rheumatoid arthritis patients and connect such results with different clinical and laboratory parameters.
Methodology: This case control study included 40 RA patients as well as 40 healthy volunteers who were age and gender matched as the control group. Patients with Rheumatoid Arthritis recruited from Rheumatology and Rehabilitation department outpatient clinic at Al-Zahraa university Hospital. Diagnosis of Rheumatoid Arthritis was according to ACR and EULAR 2010 classification criteria. An informed consent was obtained from all patients for inclusion in the study. The study subjected to be approved by the medical ethics and committee of faculty of Medicine for Girls Al-Azhar University. All patients were subjected to full clinical, Laboratory assessment, the disease activity score in 28 joints (DAS28-ESR) and nailfold capillaroscopy.
Results:  As regards to nailfold capillaroscopic findings, 11(27.5%) had avascular area, 8(20%) had micro Hemorrhage, 8(20%) had sub papillary venous plexus SPVP, 12(30%) had angiogenesis, 26(65%) had Normal U shape (hairpin) architecture, 12(30%) had tortuous architecture and 5(12.5%) had disorganized bizarre architecture, and we documented statistically significant differences between groups according to avascular area and angiogenesis.
Conclusion: Patients with RA had more non-specific capillaryscopic findings than controls. Our results didn’t support the usefulness of nailfold capillaroscopy in evaluating the disease activity in RA patients. We did not find a statistically significant relationship between capillary microscopic results and the DAS28 score. The NFC changes may occur concurrently with the joint inflammatory process.