Introduction: Primary Sjogren's syndrome (pSS) is a systemic autoimmune exocrinopathy that affects the salivary and lachrymal glands. It typically presents as the sicca complex of dry eyes (xerophthalmia) and dry mouth (xerostomia), nonetheless, musculoskeletal involvement is relatively frequent in pSS patients, even at the onset of the disease. The use of ultrasonography (US), especially with the power-doppler technique and the high-frequency transducers may be of a certain value in studying joints and tendons pathological changes related to pSS. Objective: to investigate the ultrasonographic alterations of metacarpo-phalangeal (MCP) and proximal interphalangeal (PIP) joints and flexor tendons of the fingers in a small group of pSS patients. Materials and methods: eighteen women were enrolled in the study: 9 with a diagnosis of Sjogren’s syndrome, made according to the international classification criteria for the disease, and 9 controls with sicca simptoms who showed no signs of salivary gland involvement at histological examinations. Mean age and demographic background were similar in both groups. An ultrasonographic evaluation of each single MCP and PIP was performed blindly by a single operator to detect the presence of joint effusion, erosion or synovial hyperplasia. Moreover, flexor tendons of the fingers were investigated to underline any morphological alterations. Results: Diffuse irregularities of cartilage surface and osteophytis, suggestive for osteoarthritis, were observed in in 4/9 patients with pSS and in 2/9 patients with sicca simptoms. Joint effusion was observed in 4/9 pSS and in 3/9 controls. Of the four pSS patients, one showed MCP involvement with synovial hyperplasia. No erosions were detected. As far as tendons involvement is concerned, US showed a mildly tenosynovitys of flexor tendons mainly of the second and third fingers in 2 pSS and in 2 controls. The presence of Rheumatoid Factor didn’t seem to correlate with a more severe articular involvement. Conclusion: we studied very small groups of patients so our results are preliminary. Nevertheless, despite the concomitant presence of osteoarthritis, which may explain some of the above mentioned pathological findings, our data might suggest joint involvement in a early stage of pSS. Further studies on a larger group of patients are needed.
Ultrasound evaluation of early primary Sjogren's Syndrome
RIENTE, LUCREZIA;BALDINI, CHIARA;BOMBARDIERI, STEFANO
2006-01-01
Abstract
Introduction: Primary Sjogren's syndrome (pSS) is a systemic autoimmune exocrinopathy that affects the salivary and lachrymal glands. It typically presents as the sicca complex of dry eyes (xerophthalmia) and dry mouth (xerostomia), nonetheless, musculoskeletal involvement is relatively frequent in pSS patients, even at the onset of the disease. The use of ultrasonography (US), especially with the power-doppler technique and the high-frequency transducers may be of a certain value in studying joints and tendons pathological changes related to pSS. Objective: to investigate the ultrasonographic alterations of metacarpo-phalangeal (MCP) and proximal interphalangeal (PIP) joints and flexor tendons of the fingers in a small group of pSS patients. Materials and methods: eighteen women were enrolled in the study: 9 with a diagnosis of Sjogren’s syndrome, made according to the international classification criteria for the disease, and 9 controls with sicca simptoms who showed no signs of salivary gland involvement at histological examinations. Mean age and demographic background were similar in both groups. An ultrasonographic evaluation of each single MCP and PIP was performed blindly by a single operator to detect the presence of joint effusion, erosion or synovial hyperplasia. Moreover, flexor tendons of the fingers were investigated to underline any morphological alterations. Results: Diffuse irregularities of cartilage surface and osteophytis, suggestive for osteoarthritis, were observed in in 4/9 patients with pSS and in 2/9 patients with sicca simptoms. Joint effusion was observed in 4/9 pSS and in 3/9 controls. Of the four pSS patients, one showed MCP involvement with synovial hyperplasia. No erosions were detected. As far as tendons involvement is concerned, US showed a mildly tenosynovitys of flexor tendons mainly of the second and third fingers in 2 pSS and in 2 controls. The presence of Rheumatoid Factor didn’t seem to correlate with a more severe articular involvement. Conclusion: we studied very small groups of patients so our results are preliminary. Nevertheless, despite the concomitant presence of osteoarthritis, which may explain some of the above mentioned pathological findings, our data might suggest joint involvement in a early stage of pSS. Further studies on a larger group of patients are needed.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
