Background Identifying individuals with primary Raynaud who are likely to develop scleroderma or other connective tissue diseases is very important for early control and therapeutic management of the disease and has a large influence on the patient's prognosis. The most appropriate method for this would be the capillaroscopy as it is an affordable, non-invasive and easy to use method.
Objectives To evaluate the correlation between clinical diagnosis and capillaroscopic pattern in patients with both primary and secondary Raynaud's phenomenon.
Methods We performed a descriptive observational study comprising 226 capillaroscopic assessments performed at H.U.P. La Fe in 2012-2013. All were conducted on patients with primary or secondary Raynaud's phenomenon. Rheumatologists ignored the clinical diagnosis for each case and a capillaroscopic pattern was assigned to each patient based on observed characteristics. We performed a biostatistical analysis using a multinomial logistic regression model in order to estimate the likelihood of each diagnosis based on a given capillaroscopic pattern. Biostatistical analysis of the data was performed using a multinomial logistic regression model.
Results The results obtained on the capillaroscopic assessments are: heterogeneous capillary pattern (19.5%); visible venous plexus (50.8%), normal capillary density (85.4%), decreased capillary (11%), and greatly decreased capillary density (3.5%); elongated capillary morphology (25.6%), lack of dilatation (27.4%), isolated dilatation (42%) and diffuse dilatation (30.5%); presence of mega-capillaries (26.1%); bleeding (58.4%), presence of avascular areas (5.7%), absence of windings (12.8%), presence of grade I tortuosities (31.2%), grade II tortuosities (40.7%) and grade III tortuosities (13.3%); and angiogenesis (30.5%). Based on these results, the patients were classified according to the capillaroscopic pattern and clinical diagnosis. See Table 1.
Based on these results, we observed a statistical probability of 68% of Primary Raynaud in patients with a normal capillaroscopic pattern. In addition, the presence of Grade 2 and Grade 3 tortuosity correlated positively with secondary Raynaud (p=0.0007 and p=0.024, respectively).
Conclusions Our results showed that a high percentage of cases with a regular capillaroscopic pattern had a high probability of presenting/displaying Primary Raynaud. Therefore, capillaroscopy could be useful in determining primary Raynaud's according to the pattern seen.
Disclosure of Interest None declared