Fundamentals of capillaroscopy
Core conceptual and clinical foundations for rigorous interpretation of nailfold capillaroscopy.
Overview
Here you will find a progressive foundation for understanding nailfold capillaroscopy, from core concepts and microcirculation to technique, normality, semiology, and clinical applications.
The content is designed to help you interpret findings more rigorously, use standardized language, and judge each sign within the real limits of current evidence.
You can move through the series step by step to build a solid foundation or jump straight to the unit you need when you want to solve a specific clinical or study question.
Modules and units
Each unit includes key takeaways, tables, examples, FAQ sections, and updated references. You can follow the essential path or browse by module.
Browse by module
Each block groups units with the same learning function: foundations, technique, interpretation, or clinical application.
Essential path
If you want a minimum coherent sequence before entering disease-specific deep dives or transversal topics, start with these units.
Module 1
Foundations
What capillaroscopy is, why the periungual region matters, and which anatomy and classical reading frameworks you need before interpreting anything.
3 units
Unit 01 · Level basic
Introduction to nailfold capillaroscopy
Definition, technique variants, current clinical role, limits, and historical development of nailfold capillaroscopy.
Entry unit covering what nailfold capillaroscopy is, why the nailfold is the preferred anatomical window, and what the technique currently contributes to rheumatology and vascular medicine.
Reading time: 14 min
Unit 02 · Level intermediate
Nailfold microcirculation: anatomy, physiology, and baseline findings
Capillary loop architecture, exchange physiology, and practical criteria to distinguish normal variation from microangiopathy.
Unit focused on the anatomical and physiological basis of the capillaroscopic image and on avoiding over-interpretation of nonspecific findings.
Reading time: 16 min
Unit 03 · Level intermediate
Classical semi-quantitative and quantitative capillaroscopy interpretation
How to move from global reading to classical scoring, integrate the Maricq and Cutolo patterns, and understand which metrics remain useful today.
Bridge unit between anatomical foundations and formal interpretation, organizing sequential reading, classical semi-quantification, and the current value of capillary density within a standardized framework.
Reading time: 17 min
Module 2
Technique and workflow
Equipment, acquisition, quality control, quantification, and AI. This block gathers what you need for usable and comparable studies.
1 unit
Recommended sequence
Start with Foundations, continue through Technique and workflow, and move into Interpretation before entering the clinical applications. From there, go deeper into systemic sclerosis, connective tissue diseases, myositis, and vascular autoimmune settings according to the clinical problem you want to study. Pediatrics, diabetes, and AI are especially useful once you already handle the basics and want to expand your judgment, quantification, and reproducibility.
Framework references
- Smith V, et al. Nailfold capillaroscopy. Best Pract Res Clin Rheumatol. 2023;37(1):101849.
- Smith V, et al. Standardisation of nailfold capillaroscopy for the assessment of patients with Raynaud's phenomenon and systemic sclerosis. Autoimmun Rev. 2020;19(3):102458.
- Bellando-Randone S, et al. Progression of patients with Raynaud's phenomenon to systemic sclerosis: VEDOSS registry. Lancet Rheumatol. 2021;3(12):e834-e843.