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Nailfold capillaroscopy microscopy

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capillaroscopy machine

capillaroscopy machine in healthy children and in childhood rheumatic diseases

capillaroscopy machine in healthy children and in childhood rheumatic diseases: a prospective single blind observational study Free

Abstract

Objectives: To develop an objective method of nailfold capillaroscopy (NFC), applicable to a wide age range of paediatric patients. To compare the morphological characteristics of the nailfold capillaries in different rheumatology patient groups and controls.

Methods: A colour digital video camera attached to a stereomicroscope was used to capture nailfold capillary images. Computerised image processing was used to analyse and store data. Subsequent quantitative and qualitative morphological analysis was performed in the following paediatric patient and control groups: 18 children with connective tissue diseases (CTD: juvenile dermatomyositis, systemic sclerosis, and undifferentiated connective tissue disease), eight with systemic lupus erythematosus, nine with primary Raynaud’s disease, three with primary vasculitis, 15 with juvenile idiopathic arthritis, 17 healthy children and 20 healthy adults. Images were analysed by a single assessor who was unaware of the patient details.

Results: The NFC technique was simple to perform and gave reproducible results, although some intra- and intersubject variation was noted. Capillary density and width was age related, with younger children having fewer and wider capillaries than older children and adults. Linear capillary density was significantly higher in healthy adults (mean (SD) 8.6 (1.6) capillaries/mm) compared with healthy children (HC 6.9 (0.9) capillaries/mm). The group with CTD had the most abnormal findings, with lower linear density (4.9 (1.7) capillaries/mm) and increased capillary loop width (10.7 (7.3) mm) compared with HC (3.5 (1.7) mm). In addition, 11/18 (61%) patients in the CTD group had more than two definitely abnormal capillaries in at least two nailfolds, an abnormality not seen in other subjects. Two qualitative measures, the degree of avascularity and general disarrangement of capillary pattern, were more commonly observed in the CTD group than in HC. The proportion of tortuous capillaries did not differ significantly between study groups.

Conclusions: This study is unique in measuring objective quantitative and qualitative parameters of the nailfold vasculature across a wide spectrum of age and disease. Differences in capillary morphology and frequency in children with CTD compared with other paediatric diseases and healthy controls were demonstrated. In the clinical situation, an assessment of the general degree of disarrangement may offer a fast tool for assessment of the nailfold vasculature which correlates well with NFC data.

capillaroscopy machine

What is capillaroscopy machine?

What is capillaroscopy machine?

The capillaroscopy machine is a low power microscope designed for the specific purpose of examining the small capillary blood vessels in the nail bed of the finger. This is a relatively new technique designed to study the effectiveness of the peripheral circulation and appears to have applications in chronic inflammatory conditions such as rheumatoid arthritis.

Oil such as peanut or microscopy immersion oil is applied to the skin at the base of the nail bed, this makes the peripheral capillaries of the skin visible under direct illumination and the shape and course of the vessels can be studied.

The capillaroscopy machine has been developed for this examination, and has a built in analogue CCTV camera to allow direction vision with an analogue monitor or a conventional television. The image can be displayed on PC or laptop with the aide of either an internal PCI card (for PC), or a signal converter such a WinTV (laptop) or Canopus for Apple.

The capillaroscopy machine stand has coaxial coarse and fine focus controls and a mechanical stage with coaxial adjustment to allow accurate movement and adjustment. In the centre of the stage is a finger ‘groove’ to hold the finger steady this will rotate through 360° for the optimum position, and the mechanical stage controls allows fine movement to study particular areas. The stage movement range is 25 x 70 mm.

The optical specification includes a x4 achromatic objective with a working distance of 37.4mm, which together with the CCTV unit provides an effective x50 overall magnification (without taking into account any amplification produced by the display monitor).

The capillaroscopy machine has a rheostat controlled incident light source which is non-infrared and low temperature and therefore ideally suited for the application. The angle of illumination is fully adjustable. An AC/CD 9v 500mA transformer plug is supplied .

Integral to the unit head is a colour CMOS CCTV camera with the following technical specification:

Sensor: 1/3″ 628(H) x 582(V) PAL

Resolution: 420 TV lines

Output:: 1 VP-P 75Ω

Minimum 3 Lux, auto white balance

There is a phono AVI output at the base of the microscope and the appropriate CCTV cable is supplied.

capillaroscopy machine

How to Installation and use the capillaroscopy machine?

How to Installation and use the capillaroscopy machine?

Insert the Monitor into the microscope.
Plug in 110Vto220 V power supply, and turn on the switch.
Spread a little fragrant pitch on the nail fold of the third finger on left hand and put it in the finger seat, adjust the vertical-horizontal platform to make the nail fold under the objective lens, use the structure of ascent and descent adjustment to adjust the focus until the image become clear.
Horizontally move the Light source to adjust the direction or angle of image on the monitor.

capillaroscopy machine

Abnormal capillaroscopy machine findings in patients with coronary

Abnormal capillaroscopy machine findings in patients with coronary

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