title: Clinical applicability of quantitative nailfold capillaroscopy in differential diagnosis of connective tissue diseases with Raynaud's phenomenon.
abstract: OBJECTIVE
  Nailfold capillaroscopy is a useful tool to distinguish primary from secondary Raynaud's phenomenon (RP) by examining the morphology of nailfold capillaries but its role in disease diagnosis is not clearly established. The purpose of this study was to evaluate the roles of quantitative nailfold capillaroscopy in differential diagnosis of connective tissue diseases (CTDs) with RP.
  
  
  METHODS
  The data between the year 2005 and 2009 were retrieved from the nailfold capillaroscopic database of National Taiwan University Hospital (NTUH). Only the data from the patients with RP were analyzed. The criteria for interpretation of capillaroscopic findings were predefined. The final diagnoses of the patients were based on the American College of Rheumatology classification criteria for individual diseases, independent of nailfold capillaroscopic findings. The sensitivity and the specificity of each capillaroscopic pattern to the diseases were determined.
  
  
  RESULTS
  The data from a total of 67 patients were qualified for the current study. We found the sensitivity and specificity of scleroderma pattern for systemic sclerosis (SSc) were 89.47% and 80%, and the specificity of the early, active, and late scleroderma patterns for SSc reached 87.5%, 97.5%, and 95%, respectively. The sensitivity/specificity of systemic lupus erythematosus (SLE) pattern for SLE and polymyositis/dermatomyositis (PM/DM) pattern for PM/DM were 33.33%/95.45% and 60%/96.3%, respectively. The sensitivity/specificity of mixed connective tissue disease (MCTD) pattern for MCTD were 20%/100%.
  
  
  CONCLUSIONS
  The nailfold capillaroscopic (NC) patterns may be useful in the differential diagnosis of CTDs with RP. The NC patterns for SSc and PM/DM are both sensitive and specific to the diseases, while the SLE and MCTD patterns exhibit high specificity but relatively low sensitivity.
authors.affiliation: Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Po-Chang
authors.initials: PC
authors.lastname: Wu
authors.forename: Min-Nung
authors.initials: MN
authors.lastname: Huang
authors.forename: Yu-Min
authors.initials: YM
authors.lastname: Kuo
authors.forename: Song-Chou
authors.initials: SC
authors.lastname: Hsieh
authors.forename: Chia-Li
authors.initials: CL
authors.lastname: Yu
mesh_terms: D000328:Adult; D000368:Aged; D003240:Connective Tissue Diseases / Q000175:diagnosis*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D020678:Microscopic Angioscopy / Q000379:methods*; D008875:Middle Aged; D011928:Raynaud Disease / Q000175:diagnosis*; D012680:Sensitivity and Specificity
keywords: Raynaud's phenomenon; connective tissue diseases; diagnosis; nailfold capillaroscopy