Document Detail


Ultrasonographic hand features in systemic sclerosis and correlates with clinical, biologic, and radiographic findings.
MedLine Citation:
PMID:  22422556     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To investigate ultrasonographic (US) hand features in systemic sclerosis (SSc) patients and their relationship with clinical, biologic, and radiographic data.
METHODS: Fifty-two consecutive SSc patients were included in a cross-sectional observational study together with 24 rheumatoid arthritis (RA) patients enrolled as controls. All patients underwent clinical examination, including tender and swollen joint counts, measurement of disability indices, and hand/wrist radiographs. US was performed on the hand and wrist joints and was aimed at the detection of synovitis, tenosynovitis, and calcinosis.
RESULTS: Synovitis and tenosynovitis were more frequently detected with US in SSc patients (46% and 27%, respectively) than with clinical examination (15% and 6%, respectively; P < 0.01 for both comparisons). Fifty-seven percent of patients had inflammatory synovitis (mostly Doppler grade 1), and tenosynovitis was either inflammatory or fibrotic. Calcifications were observed using US and radiographs in 40% and 36% of SSc patients, respectively (P = 0.8). As compared to RA, US features specific to SSc were sclerosing tenosynovitis (P < 0.01) and soft tissue calcifications (P = 0.01).
CONCLUSION: Our study confirms that articular involvement in SSc is underestimated by a single clinical examination. It is characterized by mild inflammatory changes and the specific findings include sclerotic US aspects together with calcinosis. Further prospective studies are warranted to evaluate the predictive value of these findings and determine whether they should be considered for adapting a therapeutic strategy.
Authors:
Muriel Elhai; Henri Guerini; Ramin Bazeli; Jerôme Avouac; Véronique Freire; Jean-Luc Drapé; André Kahan; Yannick Allanore
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Arthritis care & research     Volume:  64     ISSN:  2151-4658     ISO Abbreviation:  Arthritis Care Res (Hoboken)     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-07-31     Completed Date:  2012-10-11     Revised Date:  2013-07-22    
Medline Journal Info:
Nlm Unique ID:  101518086     Medline TA:  Arthritis Care Res (Hoboken)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1244-9     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 by the American College of Rheumatology.
Affiliation:
Paris Descartes University, Sorbonne Paris Cité, Cochin Hospital, AP-HP, France.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Arthritis, Rheumatoid / diagnosis,  radiography*,  ultrasonography*
Cross-Sectional Studies
Diagnosis, Differential
Female
Hand / radiography*,  ultrasonography*
Humans
Male
Middle Aged
Scleroderma, Systemic / diagnosis,  radiography*,  ultrasonography*
Synovitis / diagnosis,  radiography,  ultrasonography
Tenosynovitis / diagnosis,  radiography,  ultrasonography
Comments/Corrections
Comment In:
Arthritis Care Res (Hoboken). 2013 Jun;65(6):1015-6   [PMID:  23335444 ]
Arthritis Care Res (Hoboken). 2013 Jun;65(6):1016   [PMID:  23335374 ]

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