Background. Arthralgias, arthritis and loss of joint range of motion can be manifestations of systemic sclerosis (SSc). Very few data about the sonographic features of joints and tendons in patients affected by this disorder are reported in international literature. Objectives. To evaluate joint and tendon involvement of hands and wrists by ultrasound imaging technique in patients with SSc. Methods. Ultrasound examination of wrists and hands was performed, by the same physician (a rheumatologist experienced in ultrasound technique), in 10 patients (9 female and 1 male) affected by diffuse SSc using a Logiq 9 (General Electrics Medical Systems, Milwaukee, WI) with a linear probe operating at 14 MHz. All subjects were also examined with power Doppler technique. All the patients (mean age and disease duration were respectively 60.1±11.8 and 15.8±10.3 years) complained of pain in the hands or wrists. In one patient, only the wrists were studied because it was impossible to perform a correct imaging of the hands due to serious deformities of the fingers with flexion contractures. Results. We observed signs of arthritis in 8 patients. Joint effusion and synovitis were imaged in the wrists of 5 patients (50) and at the 2nd and 3rd metacarpophalangeal joints of 4 of them. Three other patients showed effusion and synovitis in metacarpophalangeal joints. A partial lesion of the carpus ulnar extensor tendon was visualized in the patient evaluated only for the wrist. Only in one patient no sonographic alterations were imaged. No abnormal vascularity was detected by power Doppler examinations. Conclusions. To date, the occurrence of arthritis in SSc patients has been considered occasional. However, we observed an unexpected high prevalence of effusion and/or synovitis in the patients enrolled in our preliminary study. Further investigations on joint and tendon involvement by ultrasound imaging technique in a larger number of patients with SSc would be useful to establish the prevalence and the features of articular and periarticular involvement.
Joint and tendon involvement of hands and wrists evaluated by ultrasound examination in patients with systemic sclerosis
BOMBARDIERI, STEFANO;RIENTE, LUCREZIA
2009-01-01
Abstract
Background. Arthralgias, arthritis and loss of joint range of motion can be manifestations of systemic sclerosis (SSc). Very few data about the sonographic features of joints and tendons in patients affected by this disorder are reported in international literature. Objectives. To evaluate joint and tendon involvement of hands and wrists by ultrasound imaging technique in patients with SSc. Methods. Ultrasound examination of wrists and hands was performed, by the same physician (a rheumatologist experienced in ultrasound technique), in 10 patients (9 female and 1 male) affected by diffuse SSc using a Logiq 9 (General Electrics Medical Systems, Milwaukee, WI) with a linear probe operating at 14 MHz. All subjects were also examined with power Doppler technique. All the patients (mean age and disease duration were respectively 60.1±11.8 and 15.8±10.3 years) complained of pain in the hands or wrists. In one patient, only the wrists were studied because it was impossible to perform a correct imaging of the hands due to serious deformities of the fingers with flexion contractures. Results. We observed signs of arthritis in 8 patients. Joint effusion and synovitis were imaged in the wrists of 5 patients (50) and at the 2nd and 3rd metacarpophalangeal joints of 4 of them. Three other patients showed effusion and synovitis in metacarpophalangeal joints. A partial lesion of the carpus ulnar extensor tendon was visualized in the patient evaluated only for the wrist. Only in one patient no sonographic alterations were imaged. No abnormal vascularity was detected by power Doppler examinations. Conclusions. To date, the occurrence of arthritis in SSc patients has been considered occasional. However, we observed an unexpected high prevalence of effusion and/or synovitis in the patients enrolled in our preliminary study. Further investigations on joint and tendon involvement by ultrasound imaging technique in a larger number of patients with SSc would be useful to establish the prevalence and the features of articular and periarticular involvement.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
