Background
Systemic sclerosis (SSc) is a chronic autoimmune connective tissue disorder.
Musculoskeletal involvement represents a major cause of disability in SSc, which is
localized especially at the level of the hands and feet. Musculoskeletal ultrasound
(MSUS) had become a reference imaging tool in the evaluation of joint and softtissue
abnormalities in rheumatic diseases.
Aim of the work
This study aimed to characterize ultrasonographic changes of the hand and wrist in
patients with SSc as compared with patients with rheumatoid arthritis (RA), as well
as determine the relation of these changes with clinical, laboratory, and
radiographic findings in SSc.
Patients and methods
Twenty SSc patients and 20 control RA patients were included in this study. All
patients underwent history taking, clinical examination, hand/wrist plain
radiography, and MSUS performed on both hand and wrist joints.
Results
MSUS was more sensitive than radiographies in detecting soft-tissue calcifications
in SSc patients and also in detecting erosions with no statistically significant
difference (P>0.05). In SSc patients, the prevalence of synovitis and
tenosynovitis detected by ultrasound was found to be statistically significantly
higher than that found by clinical examination (P=0.025 and 0.011,
respectively). Patients with higher values of erythrocyte sedimentation rate and
C-reactive protein were more likely to have synovitis and/or tenosynovitis and
inflammatory activity on power Doppler assessment.
Conclusion
Ultrasound was more accurate than clinical examination and conventional
radiography in the detection of subclinical synovitis, tenosynovitis, and the
underlying fibrotic changes of tendon friction rub. In SSc patients, on using
MSUS, articular involvement was found to be less frequent compared with that
in RA patients, with specific appearance of sclerosing tenosynovitis in SSc patients. |
