Arthritis & Rheumatism, Volume 62,
November 2010 Abstract Supplement

Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Atlanta, Georgia November 6-11, 2010.


Capillary MicroscopyA Cross-Sectional Study in the Population.

Sander1,  Oliver, Schroeder3,  Moritz, Ostendorf1,  Benedikt, Richter1,  Jutta, Reppel3,  Matthias, Acar2,  Hasan, Blumenroth4,  Martina

Dept. Rheumatology, Heinrich-Heine University, Duesseldorf, Germany
Dept. Rheumatology, Heinrich-Heine University
Heinrich-Heine University Duesseldorf
Rheumazentrum Rhein-Ruhr

Objective:

Application of capillary microscopy in the general population.

Method:

Our mobile campaign for rheumatic diseases (Rheuma-Truck) visited 26 sites in the metropolitan region Rhine-Ruhr. The visitors could participate in different tests (including capillary microscopy of fingers III-V of both hands with standardized image documentation). Demographic data, self reported symptoms based on the connective tissue screening questionnaire (CSQ), and an ad hoc diagnosis by a rheumatologist were documented. 110 outpatient visitors of the rheumatologic department were documented the same way and served as controls. The capillary images were assessed by an experienced examiner semi quantitatively regarding density, edema, bleeding, hairpin shape, caliber equalization, enlargement, giant capillaries, ramification, bushy capillaries, elongation, torsion, flow properties and filling. The results were combined with the other collected data and analyzed statistically.

Results:

3196 visitors were counted. 754 visitors underwent capillary microscopy to availability of the device (mean age 54 years, 75% female, 10,000 images evaluable). Capillary microscopy and evaluation took 1 to 2 minutes each. The costs were restricted to the purchase of the device. 8% of the sample were not assessable. 68% of the capillaries showed the normal hairpin form, torsion (17%), ramification (3%), elongation (2%), enlargement (1%) was seen in the others. Hemorrhage was seen in 5% of subjects; 4 giant capillaries were detected. Hairpin shape was seen in only 52% of the rheumatologic outpatients and 31% of patients with known systemic sclerosis. Those had higher counts of divergences, esp. giant capillaries.

There are no gender differences in the capillary morphology. The number of normal capillaries decreases slightly with age (71% in the under-30s to 65% among 70–80 year olds). A previous described association of tortured capillaries and psoriasis (in the personal and family medical history) could not be confirmed. A new diagnosis of systemic sclerosis was not identified. In fibromyalgia, the rate of normal hairpin shape capillaries was with a rate of 79% significant higher than the average for the visitors. Raynaud's phenomenon was associated with altered blood flow and capillary filling, but no detectable differences in the morphology.

Conclusion:

The expected high rate of inconspicuous findings in the visitors was confirmed, contrasting the observations in patients with rheumatic diseases. Raynaud's phenomenon was detectable by altered fillings and blood flow. The capillary microscopy is suitable for the application in larger populations.

To cite this abstract, please use the following information:
Sander, Oliver, Schroeder, Moritz, Ostendorf, Benedikt, Richter, Jutta, Reppel, Matthias, Acar, Hasan, et al; Capillary MicroscopyA Cross-Sectional Study in the Population. [abstract]. Arthritis Rheum 2010;62 Suppl 10 :1615
DOI: 10.1002/art.29381

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