Ultrasonographic features of the hand and wrist in systemic sclerosis.
OBJECTIVE
To investigate ultrasonographic hand and wrist features in patients with SSc and their correlation with clinical and X-ray examinations.


METHODS
All the patients and controls underwent clinical examination, X-ray and ultrasonography (US) evaluations of the hands and wrists. Forty-five SSc patients all of whom satisfied the ACR criteria and 45 controls-15 patients with RA, 15 patients with FM syndrome and 15 healthy subjects were assessed. US was performed by a General Electric Logiq-5 PRO using a 7-12 MHz linear array transducer.


RESULTS
Joint effusion was found in 22 (49%) SSc patients; synovial proliferation in 19 (42%), which was associated with a power Doppler signal in 11 of them; marginal bone erosions in 5 (11%); joint space narrowing in 8 (18%); periarticular calcinosis in 12 (27%); and osteophytosis in 26 (59%). In SSc patients, the prevalence of synovitis as detected by US (i.e. effusion and/or synovial proliferation) was found to be significantly higher than that found by clinical examination (i.e. tenderness and/or swelling) (26 vs 15 out of 45 cases; P = 0.03). US indicated a significantly higher number of joints with osteophytes than X-rays (59 vs 27%; P < 0.005).


CONCLUSIONS
Our study depicts the main sonographic abnormalities of the SSc hand. Using US, we found an unexpectedly high prevalence of joint pathology in SSc without clinically involved hands. The clinical usefulness of US in the assessment of SSc articular involvement either in clinical practice or in therapeutic trials is yet to be defined.
Cuomo
Giovanna
G
Department of Internal Medicine, Second University of Naples, Naples, Italy. giovanna.cuomo@unina2.it
Zappia
Marcello
M
Abignano
Giuseppina
G
Iudici
Michele
M
Rotondo
Antonio
A
Valentini
Gabriele
G
D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging; D005260:Female; D050823:Hand Joints / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D054850:Osteophyte / Q000000981:diagnostic imaging; D011859:Radiography; D012595:Scleroderma, Systemic / Q000000981:diagnostic imaging*; D016037:Single-Blind Method; D013585:Synovitis / Q000000981:diagnostic imaging; D018608:Ultrasonography, Doppler; D014955:Wrist Joint / Q000000981:diagnostic imaging*; D055815:Young Adult