title: Ultrasound imaging for the rheumatologist. XXIII. Sonographic evaluation of hand joint involvement in primary Sjögren's syndrome.
abstract: OBJECTIVE
  To study the frequency and features of joint and tendon involvement in the hand of patients with primary Sjögren's syndrome (pSS) by musculoskeletal ultrasound (US) examination.
  
  
  METHODS
  Forty-eight patients with pSS diagnosed according to the preliminary classification criteria proposed by the American-European Classification Criteria Group were enrolled in the study. Bilateral US examination of the 1st-5th metacarpophalangeal (MCP), 2nd-5th proximal interphalangeal (PIP) joints and of flexor tendons were performed. A semi-quantitative grading method (0 to 3) for scoring joint effusion, synovial proliferation and intra-articular power Doppler (PD) signal was used.
  
  
  RESULTS
  We observed clear evidence of inflammatory arthritis in 9 (18.7%) patients. Bone erosions at MCP and/or PIP joint were visualized in 6 out of 48 (12.5%) patients. In 10 (20.8%) patients we imaged flexor tenosynovitis which appeared more frequent than in healthy subjects even if no statistically significant difference was detected.
  
  
  CONCLUSIONS
  US examination appears to be a useful imaging technique to study joint and soft tissue involvement in connective tissue diseases. The presence of bone erosions in pSS patients is unexpected. Future studies will hopefully concentrate more on defining the erosive capability of connective tissue disorders together with inflammatory involvement of tendons.
authors.affiliation: Cattedra di Reumatologia, Università di Pisa, Italy. l.riente@int.med.unipi.it
authors.forename: L
authors.initials: L
authors.lastname: Riente
authors.forename: C A
authors.initials: CA
authors.lastname: Scirè
authors.forename: A
authors.initials: A
authors.lastname: Delle Sedie
authors.forename: C
authors.initials: C
authors.lastname: Baldini
authors.forename: E
authors.initials: E
authors.lastname: Filippucci
authors.forename: G
authors.initials: G
authors.lastname: Meenagh
authors.forename: A
authors.initials: A
authors.lastname: Iagnocco
authors.forename: C
authors.initials: C
authors.lastname: Montecucco
authors.forename: W
authors.initials: W
authors.lastname: Grassi
authors.forename: G
authors.initials: G
authors.lastname: Valesini
authors.forename: S
authors.initials: S
authors.lastname: Bombardieri
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D005260:Female; D050823:Hand Joints / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012859:Sjogren's Syndrome / Q000000981:diagnostic imaging*; D014463:Ultrasonography; D055815:Young Adult