Division of Rheumatology, ASST Gaetano Pini, Department of Clinical Sciences and Community Health, Università degli Studi di Milano, P.zza Cardinal Ferrari 1, 20122, Milan, Italy.
Centre for Musculoskeletal Research, The University of Manchester, Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK.
Rheumatol Int. 2017 Nov;37(11):1879-1890. doi: 10.1007/s00296-017-3808-0. Epub 2017 Sep 11.
To canvas opinion concerning the role of non-invasive techniques in the assessment of patients with Raynaud's phenomenon (Rp) in clinical and research settings: four nailfold capillaroscopy methods [videocapillaroscopy (NVC), dermoscopy, stereomicroscopy, digital USB microscopy], four laser Doppler methods (laser Doppler flowmetry, imaging, anemometry/velocimetry, laser speckle contrast analysis), thermographic imaging, and upper limb arterial Doppler ultrasound. Emails with a link to the survey were sent to physicians from the European Scleroderma Trials and Research group (EUSTAR), the EULAR Study Group on Microcirculation in Rheumatic Diseases (SG_MC/RD) and members of the pediatric rheumatology Email board. The main descriptive analysis related to physicians looking after adult patients, with some analysis also of opinions from paediatric rheumatologists. 106 'adult physicians' responded (a response rate of 25.8%), of whom 68.9% were European, and 81.1% practising for more than 10 years. Nineteen paediatricians responded. The most widely available technique was NVC (72.7%). Nailfold capillaroscopy was most frequently performed by the physician him/herself, using different types of equipment relating to availability. Most rheumatologists reported high levels of appropriateness for NVC in both clinical and research settings for global assessment and differential diagnosis of Rp. Other techniques were less used. Of all the different techniques, nailfold capillaroscopy was the one most used in both clinical and research settings by adult physicians, the majority of whom use NVC in their everyday practice. The low proportion of clinicians using other techniques suggests that these are currently mainly research tools, available only in specialist centres.
为了调查在临床和研究环境中评估雷诺现象（Rp）患者时非侵入性技术的作用的意见：四种甲襞毛细血管镜方法[视频甲襞显微镜（NVC）、皮肤镜、立体显微镜、数字 USB 显微镜]、四种激光多普勒方法（激光多普勒流量测定法、成像、气流/流速测定法、激光散斑对比分析）、热成像和上肢动脉多普勒超声。向欧洲硬皮病试验和研究组（EUSTAR）、欧洲风湿病微循环研究组（SG_MC/RD）的医生以及儿科风湿病学电子邮件委员会的成员发送了带有调查链接的电子邮件。主要描述性分析与照顾成年患者的医生有关，也对儿科风湿病学家的意见进行了一些分析。106 名“成年医生”做出了回应（回应率为 25.8%），其中 68.9%来自欧洲，81.1%的医生从业时间超过 10 年。19 名儿科医生做出了回应。最广泛使用的技术是 NVC（72.7%）。甲襞毛细血管镜最常由医生本人使用不同类型的设备进行，这取决于设备的可用性。大多数风湿病学家报告称，在临床和研究环境中，NVC 非常适合用于 Rp 的整体评估和鉴别诊断。其他技术的使用较少。在所有不同的技术中，甲襞毛细血管镜是成年医生在临床和研究环境中最常使用的技术，其中大多数医生在日常实践中使用 NVC。使用其他技术的临床医生比例较低，这表明这些技术目前主要是研究工具，仅在专门中心提供。
