The role of ultrasound imaging in the evaluation of peripheral nerve in systemic sclerosis (scleroderma).
BACKGROUND
Patients affected by scleroderma may complain of sensory disturbances especially in the hands.


OBJECTIVE
To study the imaging features of upper limb nerves in patients affected by scleroderma (SSc).


METHODS
Twenty-five patients affected only by SSc were prospectively evaluated with high-resolution US and magnetic resonance (MRI) or computer tomography (CT) when necessary (2 patients). Median and ulnar nerves were evaluated bilaterally. Nerve conduction studies were performed in the symptomatic patients (n = 10). Results of imaging studies were correlated with disease duration, autoimmunity and immunosuppression. Nerves of SSc patients were compared with a control group of 90 patients matched for age and body mass index.


RESULTS
The prevalence of sensory disturbances revealed by clinical examination was 40%. In symptomatic SSc patients (n = 10) US evaluation revealed nerve abnormalities in 70% of cases (n = 7/10). n = 2 had a carpal tunnel syndrome. n = 5 had cubital tunnel syndrome. In two of them CT and MR were necessary to identify the compressed nerve at the level of the elbow due to the presence of calcifications. There was no association between the presence of an entrapment neuropathy and disease duration, autoantibodies and immunosuppression.


CONCLUSIONS
Ultrasound, CT and MR may detect nerve abnormalities in 70% of SSc patients complaining of neurologic disturbances in the hands. The results of imaging studies support the hypothesis of a vascular dependent neuropathy in SSc.
Department of Radiology, University of Genova, Genova, Italy. atagliafico@sirm.org
Alberto
A
Tagliafico
Nicoletta
N
Panico
Eugenia
E
Resmini
Lorenzo E
LE
Derchi
Massimo
M
Ghio
Carlo
C
Martinoli
D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010523:Peripheral Nervous System Diseases / Q000150:complications* / Q000000981:diagnostic imaging*; D015203:Reproducibility of Results; D012595:Scleroderma, Systemic / Q000150:complications* / Q000000981:diagnostic imaging*; D012680:Sensitivity and Specificity; D014463:Ultrasonography / Q000379:methods*