title: Characteristics of joint involvement and relationships with systemic inflammation in systemic sclerosis: results from the EULAR Scleroderma Trial and Research Group (EUSTAR) database.
abstract: OBJECTIVE
  To determine the prevalence of and independent factors associated with joint involvement in a large population of patients with systemic sclerosis (SSc).
  
  
  METHODS
  This study was cross-sectional, based on data collected on patients included in the European League Against Rheumatism (EULAR) Scleroderma Trials and Research (EUSTAR) registry. We queried this database to extract data regarding global evaluation of patients with SSc and the presence of any clinical articular involvement: synovitis (tender and swollen joints), tendon friction rubs (rubbing sensation detected as the tendon was moved), and joint contracture (stiffness of the joints that decreased their range of motion). Overall joint involvement was defined by the occurrence of synovitis and/or joint contracture and/or tendon friction rubs.
  
  
  RESULTS
  We recruited 7286 patients with SSc; their mean age was 56 +/- 14 years, disease duration 10 +/- 9 years, and 4210 (58%) had a limited cutaneous disease subset. Frequencies of synovitis, tendon friction rubs, and joint contractures were 16%, 11%, and 31%, respectively. Synovitis, tendon friction rubs, and joint contracture were more prevalent in patients with the diffuse cutaneous subset and were associated together and with severe vascular, muscular, renal, and interstitial lung involvement. Moreover, synovitis had the highest strength of association with elevated acute-phase reactants taken as the dependent variable.
  
  
  CONCLUSIONS
  Our results highlight the striking level of articular involvement in SSc, as evaluated by systematic examination in a large cohort of patients with SSc. Our data also show that synovitis, joint contracture, and tendon friction rubs are associated with a more severe disease and with systemic inflammation.
authors.affiliation: Service de Rhumatologie A, Hôpital Cochin, Université Paris Descartes, 75014 Paris, France.
authors.forename: Jerome
authors.initials: J
authors.lastname: Avouac
authors.forename: Ulrich
authors.initials: U
authors.lastname: Walker
authors.forename: Alan
authors.initials: A
authors.lastname: Tyndall
authors.forename: André
authors.initials: A
authors.lastname: Kahan
authors.forename: Marco
authors.initials: M
authors.lastname: Matucci-Cerinic
authors.forename: Yannick
authors.initials: Y
authors.lastname: Allanore
authors.forename: I
authors.initials: I
authors.lastname: Miniati
authors.forename: A
authors.initials: A
authors.lastname: Muller
authors.forename: F
authors.initials: F
authors.lastname: Iannone
authors.forename: O
authors.initials: O
authors.lastname: Distler
authors.forename: R
authors.initials: R
authors.lastname: Becvar
authors.forename: S
authors.initials: S
authors.lastname: Sierakowsky
authors.forename: O
authors.initials: O
authors.lastname: Kowal-Bielecka
authors.forename: P
authors.initials: P
authors.lastname: Coelho
authors.forename: J
authors.initials: J
authors.lastname: Cabane
authors.forename: M
authors.initials: M
authors.lastname: Cutolo
authors.forename: Y
authors.initials: Y
authors.lastname: Shoenfeld
authors.forename: G
authors.initials: G
authors.lastname: Valentini
authors.forename: J
authors.initials: J
authors.lastname: Rovensky
authors.forename: G
authors.initials: G
authors.lastname: Riemekasten
authors.forename: P
authors.initials: P
authors.lastname: Vlachoyiannopoulos
authors.forename: R
authors.initials: R
authors.lastname: Caporali
authors.forename: S
authors.initials: S
authors.lastname: Jiri
authors.forename: M
authors.initials: M
authors.lastname: Inanc
authors.forename: I
authors.initials: I
authors.lastname: Zimmermann Gorska
authors.forename: P
authors.initials: P
authors.lastname: Carreira
authors.forename: S
authors.initials: S
authors.lastname: Novak
authors.forename: L
authors.initials: L
authors.lastname: Czirjak
authors.forename: F
authors.initials: F
authors.lastname: Oliveira Ramos
authors.forename: M
authors.initials: M
authors.lastname: Jendro
authors.forename: C
authors.initials: C
authors.lastname: Chizzolini
authors.forename: E J
authors.initials: EJ
authors.lastname: Kucharz
authors.forename: J
authors.initials: J
authors.lastname: Richter
authors.forename: F
authors.initials: F
authors.lastname: Cozzi
authors.forename: B
authors.initials: B
authors.lastname: Rozman
authors.forename: C M
authors.initials: CM
authors.lastname: Mallia
authors.forename: A
authors.initials: A
authors.lastname: Gabrielli
authors.forename: D
authors.initials: D
authors.lastname: Farge
authors.forename: H P
authors.initials: HP
authors.lastname: Kiener
authors.forename: D
authors.initials: D
authors.lastname: Schöffel
authors.forename: P
authors.initials: P
authors.lastname: Airo
authors.forename: F
authors.initials: F
authors.lastname: Wollheim
authors.forename: D
authors.initials: D
authors.lastname: Martinovic
authors.forename: F
authors.initials: F
authors.lastname: Trotta
authors.forename: S
authors.initials: S
authors.lastname: Jablonska
authors.forename: K
authors.initials: K
authors.lastname: Reich
authors.forename: S
authors.initials: S
authors.lastname: Bombardieri
authors.forename: P
authors.initials: P
authors.lastname: Siakka
authors.forename: R
authors.initials: R
authors.lastname: Pellerito
authors.forename: L M
authors.initials: LM
authors.lastname: Bambara
authors.forename: J
authors.initials: J
authors.lastname: Morovic-Vergles
authors.forename: C
authors.initials: C
authors.lastname: Denton
authors.forename: R
authors.initials: R
authors.lastname: Hinrichs
authors.forename: F
authors.initials: F
authors.lastname: Van den Hoogen
authors.forename: N
authors.initials: N
authors.lastname: Damjanov
authors.forename: I
authors.initials: I
authors.lastname: Kötter
authors.forename: V
authors.initials: V
authors.lastname: Ortiz
authors.forename: S
authors.initials: S
authors.lastname: Heitmann
authors.forename: D
authors.initials: D
authors.lastname: Krasowska
authors.forename: M
authors.initials: M
authors.lastname: Seidel
authors.forename: P
authors.initials: P
authors.lastname: Hasler
authors.forename: J M
authors.initials: JM
authors.lastname: Van Laar
authors.forename: J P
authors.initials: JP
authors.lastname: Kaltwasser
authors.forename: I
authors.initials: I
authors.lastname: Foeldvari
authors.forename: A
authors.initials: A
authors.lastname: Juan Mas
authors.forename: G
authors.initials: G
authors.lastname: Bajocchi
authors.forename: M
authors.initials: M
authors.lastname: Wislowska
authors.forename: J A
authors.initials: JA
authors.lastname: Pereira Da Silva
authors.forename: S
authors.initials: S
authors.lastname: Jacobsen
authors.forename: M
authors.initials: M
authors.lastname: Worm
authors.forename: W
authors.initials: W
authors.lastname: Graniger
authors.forename: A
authors.initials: A
authors.lastname: Kuhn
authors.forename: A
authors.initials: A
authors.lastname: Stankovic
authors.forename: R
authors.initials: R
authors.lastname: Cossutta
authors.forename: M
authors.initials: M
authors.lastname: Majdan
authors.forename: L
authors.initials: L
authors.lastname: Damjanovska Rajcevska
authors.forename: M
authors.initials: M
authors.lastname: Tikly
authors.forename: E L
authors.initials: EL
authors.lastname: Nasonov
authors.forename: K
authors.initials: K
authors.lastname: Steinbrink
authors.forename: A
authors.initials: A
authors.lastname: Herrick
authors.forename: U
authors.initials: U
authors.lastname: Müller-Ladner
authors.forename: A
authors.initials: A
authors.lastname: Dinc
authors.forename: R
authors.initials: R
authors.lastname: Scorza
authors.forename: K
authors.initials: K
authors.lastname: Sondergaard
authors.forename: F
authors.initials: F
authors.lastname: Indiveri
authors.forename: H
authors.initials: H
authors.lastname: Nielsen
authors.forename: Z
authors.initials: Z
authors.lastname: Szekanecz
authors.forename: R M
authors.initials: RM
authors.lastname: Silver
authors.forename: M
authors.initials: M
authors.lastname: Antivalle
authors.forename: I B
authors.initials: IB
authors.lastname: Espinosa
authors.forename: P
authors.initials: P
authors.lastname: García de la Pena Lefebvre
authors.forename: O
authors.initials: O
authors.lastname: Midtvedt
authors.forename: D
authors.initials: D
authors.lastname: Launay
authors.forename: F
authors.initials: F
authors.lastname: Valesini
authors.forename: P
authors.initials: P
authors.lastname: Tuvik
authors.forename: R M
authors.initials: RM
authors.lastname: Ionescu
authors.forename: N
authors.initials: N
authors.lastname: Del Papa
authors.forename: S
authors.initials: S
authors.lastname: Pinto
authors.forename: F
authors.initials: F
authors.lastname: Wigley
authors.forename: C
authors.initials: C
authors.lastname: Mihai
authors.forename: M
authors.initials: M
authors.lastname: Sinziana Capranu
authors.forename: C
authors.initials: C
authors.lastname: Sunderkötter
authors.forename: J B
authors.initials: JB
authors.lastname: Jun
authors.forename: S
authors.initials: S
authors.lastname: Alhasani
authors.forename: J H
authors.initials: JH
authors.lastname: Distler
authors.forename: E
authors.initials: E
authors.lastname: Ton
authors.forename: T
authors.initials: T
authors.lastname: Soukup
authors.forename: J
authors.initials: J
authors.lastname: Seibold
authors.forename: S
authors.initials: S
authors.lastname: Zeni
authors.forename: P
authors.initials: P
authors.lastname: Nash
authors.forename: L
authors.initials: L
authors.lastname: Mouthon
authors.forename: F
authors.initials: F
authors.lastname: De Keyser
authors.forename: M T
authors.initials: MT
authors.lastname: Duruöz
authors.forename: F P
authors.initials: FP
authors.lastname: Cantatore
authors.forename: G
authors.initials: G
authors.lastname: Strauss
authors.forename: C A
authors.initials: CA
authors.lastname: von Mülhen
authors.forename: M R
authors.initials: MR
authors.lastname: Pozzi
authors.forename: K
authors.initials: K
authors.lastname: Eyerich
authors.forename: J
authors.initials: J
authors.lastname: Szechinski
authors.forename: M
authors.initials: M
authors.lastname: Keiserman
authors.forename: F A
authors.initials: FA
authors.lastname: Houssiau
authors.forename: J A
authors.initials: JA
authors.lastname: Román-Ivorra
authors.forename: B
authors.initials: B
authors.lastname: Krummel-Lorenz
authors.forename: M
authors.initials: M
authors.lastname: Aringer
authors.forename: R
authors.initials: R
authors.lastname: Westhovens
authors.forename: F
authors.initials: F
authors.lastname: Bellisai
authors.forename: M
authors.initials: M
authors.lastname: Mayer
authors.forename: F
authors.initials: F
authors.lastname: Stoeckl
authors.forename: M
authors.initials: M
authors.lastname: Uprus
authors.forename: A
authors.initials: A
authors.lastname: Volpe
authors.forename: M
authors.initials: M
authors.lastname: Buslau
authors.forename: S
authors.initials: S
authors.lastname: Yavuz
authors.forename: B
authors.initials: B
authors.lastname: Granel
authors.forename: A
authors.initials: A
authors.lastname: Valderílio Feijó
authors.forename: F
authors.initials: F
authors.lastname: Del Galdo
authors.forename: S
authors.initials: S
authors.lastname: Popa
authors.forename: T
authors.initials: T
authors.lastname: Zenone
authors.forename: X
authors.initials: X
authors.lastname: Ricardo Machado
authors.forename: M
authors.initials: M
authors.lastname: Pileckyte
authors.forename: S
authors.initials: S
authors.lastname: Stebbings
authors.forename: A
authors.initials: A
authors.lastname: Mathieu
authors.forename: A
authors.initials: A
authors.lastname: Tulli
authors.forename: T
authors.initials: T
authors.lastname: Tourinho
authors.forename: R
authors.initials: R
authors.lastname: Souza
authors.forename: R
authors.initials: R
authors.lastname: Acayaba de Toledo
authors.forename: L
authors.initials: L
authors.lastname: Stamp
authors.forename: K
authors.initials: K
authors.lastname: Solanki
authors.forename: D
authors.initials: D
authors.lastname: Veale
authors.forename: J
authors.initials: J
authors.lastname: Francisco Marques Neto
authors.forename: G F
authors.initials: GF
authors.lastname: Bagnato
authors.forename: E
authors.initials: E
authors.lastname: Loyo
authors.forename: S
authors.initials: S
authors.lastname: Toloza
authors.forename: M
authors.initials: M
authors.lastname: Li
authors.forename: W
authors.initials: W
authors.lastname: Ahmed Abdel Atty Mohamed
authors.forename: V
authors.initials: V
authors.lastname: Cobankara
authors.forename: J
authors.initials: J
authors.lastname: Olas
authors.forename: F
authors.initials: F
authors.lastname: Salsano
authors.forename: F
authors.initials: F
authors.lastname: Oksel
authors.forename: C M
authors.initials: CM
authors.lastname: Tanaseanu
authors.forename: R
authors.initials: R
authors.lastname: Foti
authors.forename: C
authors.initials: C
authors.lastname: Ancuta
authors.forename: M
authors.initials: M
authors.lastname: Vonk
authors.forename: P
authors.initials: P
authors.lastname: Caramashi
authors.forename: L
authors.initials: L
authors.lastname: Beretta
authors.forename: A
authors.initials: A
authors.lastname: Balbir
authors.forename: A
authors.initials: A
authors.lastname: Chiàla
authors.forename: K
authors.initials: K
authors.lastname: Pasalic Simic
authors.forename: M
authors.initials: M
authors.lastname: Ghio
authors.forename: B
authors.initials: B
authors.lastname: Stamenkovic
authors.forename: S
authors.initials: S
authors.lastname: Rednic
authors.forename: N
authors.initials: N
authors.lastname: Host
authors.forename: R
authors.initials: R
authors.lastname: Pellerito
authors.forename: E
authors.initials: E
authors.lastname: Hachulla
authors.forename: D E
authors.initials: DE
authors.lastname: Furst
mesh_terms: D000328:Adult; D000368:Aged; D002986:Clinical Trials as Topic; D003430:Cross-Sectional Studies; D016208:Databases, Factual; D005260:Female; D006801:Humans; D007249:Inflammation / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D007592:Joint Diseases / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D007596:Joints / Q000473:pathology; D008297:Male; D008875:Middle Aged; D016059:Range of Motion, Articular; D012594:Scleroderma, Localized / Q000209:etiology / Q000473:pathology*; D012595:Scleroderma, Systemic / Q000150:complications / Q000473:pathology / Q000503:physiopathology; D013585:Synovitis / Q000209:etiology / Q000473:pathology; D013710:Tendons / Q000473:pathology