Capillaroscopy in Raynaud phenomenon

Margaret J. Larché is a professor of medicine in the Division of Rheumatology at McMaster University and director of the Canadian Scleroderma Research Group (CSRG).

Should we perform capillaroscopy in every patient with Raynaud phenomenon?

I believe we should be performing capillaroscopy on everybody. It’s easy, it’s quick, you can use the tools that you already have in your office to look at the capillaries. You should just practice on yourself. For example, you can use an ophthalmoscope that you have in clinic.

It has a prognostic implication if those nailfolds are dilated. It’s definitely worth looking at some images of normal versus abnormal so you get an idea of what’s that. If you have dilated nailfold capillaries in somebody with new-onset Raynaud, I would watch that patient much more carefully than if you had a young woman who presented with Raynaud and normal nailfold capillaries.