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Clinical practice guidelines for reporting nail fold videocapillaroscopy: a Delphi consensus on behalf of the Italian Society of Rheumatology study group on capillaroscopy

1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56

 

  1. Clinica Reumatologica, Dipartimento di Reumatologia e Scienze Mediche, ASST Gaetano Pini-CTO, Milano; and Dipartimento di Scienze Cliniche e di Comunità, Dipartimento di Eccellenza 2023-2027, Università degli Studi di Milano, Italy. francesca.ingegnoli@unimi.it
  2. Clinica Reumatologica, Dipartimento di Reumatologia e Scienze Mediche, ASST Gaetano Pini-CTO, Milano; and Dipartimento di Scienze Cliniche e di Comunità, Dipartimento di Eccellenza 2023-2027, Università degli Studi di Milano, Italy.
  3. Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Italy.
  4. Rheumatology Clinic, Polytechnic University of Marche, Department of Clinical and Molecular Science, Jesi, Ancona, Italy.
  5. Department of Life, Health and Environmental Sciences, University of L’Aquila; Internal Medicine and Nephrology Division, Avezzano-Sulmona-L’Aquila Local Health Authority 1, San Salvatore Hospital, L’Aquila, Italy.
  6. Department of Medicine, Internal Medicine and Rheumatology, Azienda Ospedaliera Universitaria di Parma, Italy.
  7. Ambulatorio di Reumatologia, Ospedale Versilia, ASL Toscana Nord Ovest, Lido di Camaiore, Lucca, Italy.
  8. Unità di Immunologia, Reumatologia, Allergologia e Malattie Rare, IRCCS San Raffaele, Milano, Italy.
  9. Division of Rheumatology, Multispecialist Medical Department, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.
  10. SS Reumatologia, Medicina Interna e Reumatologia, ASL Romagna, Ospedale Infermi, Rimini, Italy.
  11. Rheumatology Division, Catholic University of the Sacred Heart, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy.
  12. Rheumatology Unit, Department of Precision and Regenerative Medicine-Ionian Area, University of Bari Aldo Moro, Bari; Rheumatology Service, Internal Medicine Unit, F. Miulli General Hospital, Acquaviva delle Fonti, Department of Medicine and Surgery, LUM G. De Gennaro, Casamassima, Bari, Italy.
  13. Casa di Cura Beato Palazzolo, Bergamo, Italy.
  14. Istituto Clinico Beato Matteo, Vigevano, Italy.
  15. Department of Life, Health and Environmental Sciences, University of L’Aquila; Internal Medicine and Nephrology Division, Avezzano-Sulmona-L’Aquila Local Health Authority 1, San Salvatore Hospital, L’Aquila, Italy.
  16. Rheumatology and Clinical Immunology, ASST Spedali Civili of Brescia; Department of Clinical and Experimental Sciences, University of Brescia, Italy.
  17. Department of Internal Medicine and Therapeutics, Università di Pavia; Division of Rheumatology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
  18. Department of Clinical and Experimental Medicine, University of Catania, Italy.
  19. Clinica Reumatologica, Dipartimento di Reumatologia e Scienze Mediche, ASST Gaetano Pini-CTO, Milano; and Dipartimento di Scienze Cliniche e di Comunità, Dipartimento di Eccellenza 2023-2027, Università degli Studi di Milano, Italy.
  20. Department of Precision Medicine, Univerisity of Campania, Luigi Vanvitelli University, Naples, Italy.
  21. Clinica di Reumatologia, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy.
  22. Department of Rheumatology, University of Pisa, Italy.
  23. Department of Rheumatology, University of Pisa, Italy.
  24. Department of Life, Health and Environmental Sciences, University of L’Aquila; Internal Medicine and Nephrology Division, Avezzano-Sulmona-L’Aquila Local Health Authority 1, San Salvatore Hospital, L’Aquila, Italy.
  25. UOC Reumatologia, ASST Ovest Milanese, Legnano, Milano, Italy.
  26. Internal Medicine 1, Ca’ Foncello University Hospital, AULSS2, Treviso, Italy.
  27. Division of Rheumatology, AOU Policlinico G. Rodolico San Marco Catania, Italy.
  28. UOS Reumatologia, Ospedale GB Morgagni-Pierantoni di Forlì, Italy.
  29. Department of Medical and Surgical Sciences for Children and Adults, University Hospital of Modena and Reggio Emilia School of Medicine, Modena, Italy.
  30. Department of Experimental and Clinical Medicine, University of Florence; Department of Internal Medicine, Division of Rheumatology AOUC, Florence, Italy.
  31. Laboratory of Experimental Rheumatology and Academic Division of Clinical Rheumatology, Department of Internal Medicine and Medical Specialties (Di.M.I.), IRCCS Ospedale Policlinico San Martino, University of Genova, Italy.
  32. SS Reumatologia, UOC Medicina Interna, Ospedale Michele e Pietro Ferrero, ASL CN2, Verduno, Italy.
  33. Laboratory of Experimental Rheumatology and Academic Division of Clinical Rheumatology, Department of Internal Medicine and Medical Specialties (Di.M.I.), IRCCS Ospedale Policlinico San Martino, University of Genova, Italy.
  34. UOC Reumatologia, AO San Camillo-Forlanini, Roma, Italy.
  35. Rheumatology, Department of Medicine and Surgery, University of Perugia, Italy.
  36. Rheumatology Unit, Hospital S. Chiara, Trento, Italy.
  37. Division of Rheumatology, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
  38. Reumatologia, Ospedale San Carlo, Potenza, Italy.
  39. Department of Clinical and Molecular Sciences, Marche Polytechnic University, Ancona, Italy.
  40. Department of Rheumatology, IRCCS Ospedale Galeazzi-Sant’Ambrogio, Milan; and Dipartimento di Scienze Biomediche e Cliniche, Università degli Studi di Milano, Italy.
  41. Rheumatology, Department of Medicine and Surgery, University of Perugia, Italy.
  42. Laboratory of Experimental Rheumatology and Academic Division of Clinical Rheumatology, Department of Internal Medicine and Medical Specialties (Di.M.I.), IRCCS Ospedale Policlinico San Martino, University of Genova, Italy.
  43. U.O.S.V.D. Reumatologia e Rischio Oncologico, P.O. Mons. R. Dimiccoli Barletta, ASL BT Andria, Italy.
  44. U.O. Reumatologia, Ospedale Antonio Galateo, San Cesario, Lecce, Italy.
  45. UOC Medicina Interna Lodi, ASST di Lodi, Ospedale Maggiore di Lodi, Italy.
  46. U.O.S.V.D. Reumatologia e Rischio Oncologico, P.O. Mons. R. Dimiccoli Barletta, ASL BT Andria, Italy.
  47. S.C. Reumatologia, Ospedale La Colletta, ASL3 Genovese, Arenzano, Italy.
  48. Rheumatology Unit, AUSL Piacenza; Department of Medicine and Surgery, University of Parma, Italy.
  49. UOS Reumatologia, PO San Paolo, Bari, Italy.
  50. S.C. Reumatologia, Ospedale La Colletta, ASL3 Genovese, Arenzano, Italy.
  51. SSD Reumatologia Azienda Sanitaria Ospedaliera S.S.Antonio e Biagio e C. Arrigo, Alessandria, Italy.
  52. Laboratory of Experimental Rheumatology and Academic Division of Clinical Rheumatology, Department of Internal Medicine and Medical Specialties (Di.M.I.), IRCCS Ospedale Policlinico San Martino, University of Genova, Italy.
  53. Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Italy.
  54. Department of Rheumatology and Department of Internal Medicine, Ghent University Hospital, University of Ghent, Unit for Molecular Immunology and Inflammation, Flemish Institute for Biotechnology, Inflammation Research Centre, Ghent, Belgium.
  55. Laboratory of Experimental Rheumatology and Academic Division of Clinical Rheumatology, Department of Internal Medicine and Medical Specialties (Di.M.I.), IRCCS Ospedale Policlinico San Martino, University of Genova, Italy.
  56. Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Italy.

On behalf of the Study Group on Capillaroscopy and Microcirculation in Rheumatic Diseases of the Italian Society of Rheumatology (CAPSIR)

CER19107
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PMID: 41537537 [PubMed]

Received: 16/07/2025
Accepted : 22/09/2025
In Press: 15/01/2026

Abstract

OBJECTIVES:
In clinical practice, standardised reporting of nailfold videocapillaroscopy (NVC) findings is lacking, making the interpretation and comparison of results difficult. We aimed to achieve a national consensus on how to describe NVC findings in routine clinical practice.
METHODS:
A web-based Delphi consensus study was conducted among members of the Study Group on Capillaroscopy and Microcirculation in Rheumatic Diseases of the Italian Society of Rheumatology (CAPSIR). The study was based on items derived from a previous systematic review and international consensus by the EULAR Study Group on Microcirculation in Rheumatic Diseases (SG_MC/RD).
RESULTS:
A total of 40 items were proposed during the Delphi process, which was completed by 52 participants from different Italian regions. An agreement was reached on 23 items covering different aspects of the NVC examination: general aspects (2 items), description of the fingers examined (3 items), possible confounding factors (2 items), device description (2 items), image quality (1 item) and details of the NVC examination (13 items). Sixteen of these were considered mandatory for inclusion in the NVC practice report, and 7 were considered optional.
CONCLUSIONS:
The proposed NVC checklist covers 23 relevant issues in clinical practice, including 16 mandatory items grouped into five categories. This national consensus will improve the reproducibility and generalisability of NVC reporting in daily clinical practice. Furthermore, the outcomes of this NVC consensus process will inform the next European web-based Delphi consensus study, to be conducted among the member countries of the EULAR SG_MC/RD.

DOI: https://doi.org/10.55563/clinexprheumatol/2z4j95

Rheumatology Article

Rheumatology Addendum