title: The thickness of the A1 pulleys reflects the disability of hand mobility in scleroderma. A pilot study using high-frequency ultrasound.
abstract: BACKGROUND
  Hand involvement in scleroderma is a serious concern. Clinical tests to asses hand dysfunction are based on the experience of the clinician.
  
  
  OBJECTIVE
  To asses if utrasonographic (US) measurement of A1 pulley thickness may be used as an indicator of hand mobility in scleroderma.
  
  
  METHODS
  Institutional review board approval and patient informed consent was obtained. Twenty-eight patients affected suffering from scleroderma and 40 healthy controls were prospectively evaluated by two blinded radiologists with US, with a transducer operating at 17MHz. A1 pulley thickness was measured and correlated with the Hand Mobility in Scleroderma Test (HAMIS) and disease duration.
  
  
  RESULTS
  The thickness of the A1 pulley was greater in sclerodermic patients than in controls (p < 0.05). Intra and inter-observer agreement were better for ultrasound (0.94;0.88) than for HAMIS tests (0.71;0.70). A good correlation between pulley thickness, hand mobility and disease duration was found (r = 0.78, p < 0.018; r = 0.54, p < 0.05).
  
  
  CONCLUSIONS
  A1 pulley thickness measured on ultrasound correlates with hand mobility and disease duration. Ultrasound is an useful tool to evaluate hand disability in scleroderma.
authors.affiliation: Department of Radiology, National Institute for Cancer Research, Genova, Italy. atagliafico@sirm.org
authors.forename: Alberto
authors.initials: A
authors.lastname: Tagliafico
authors.forename: Nicoletta
authors.initials: N
authors.lastname: Panico
authors.forename: Giovanni
authors.initials: G
authors.lastname: Serafini
authors.forename: Massimo
authors.initials: M
authors.lastname: Ghio
authors.forename: Carlo
authors.initials: C
authors.lastname: Martinoli
mesh_terms: D005260:Female; D005384:Finger Joint / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D015203:Reproducibility of Results; D012595:Scleroderma, Systemic / Q000150:complications / Q000000981:diagnostic imaging*; D012680:Sensitivity and Specificity; D013710:Tendons / Q000000981:diagnostic imaging*; D014463:Ultrasonography / Q000379:methods*