title: Ultrasonographic features of the hand and wrist in systemic sclerosis.
abstract: 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.
authors.affiliation: Department of Internal Medicine, Second University of Naples, Naples, Italy. giovanna.cuomo@unina2.it
authors.forename: Giovanna
authors.initials: G
authors.lastname: Cuomo
authors.forename: Marcello
authors.initials: M
authors.lastname: Zappia
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Abignano
authors.forename: Michele
authors.initials: M
authors.lastname: Iudici
authors.forename: Antonio
authors.initials: A
authors.lastname: Rotondo
authors.forename: Gabriele
authors.initials: G
authors.lastname: Valentini
mesh_terms: 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