Hand radiological damage in systemic sclerosis: comparison with a control group and clinical and functional correlations.
OBJECTIVE
To define the burden of hand radiological damage in systemic sclerosis (SSc) patients, compared with a control group.


METHODS
Both hands of 167 SSc patients and 168 hands (82 right and 86 left) of age- and gender-matched controls were imaged by conventional radiograph. Two musculoskeletal radiologists semiquantitatively scored the following lesions: tuft acro-osteolysis, tuft calcinosis, joint space narrowings, marginal erosions, surface erosions, collapse arthropathies, periarticular calcifications, and juxta-articular osteoporosis, at the following areas: tufts, distal interphalangeal, proximal interphalangeal, metacarpophalangeal, carpal, and first carpometacarpal joints. Clinical and functional characteristics of the 167 SSc patients were obtained from the Belgian Systemic Sclerosis Cohort database.


RESULTS
Tuft acro-osteolysis and calcinosis were the most common findings observed in SSc patients and were almost absent in controls. SSc patients displaying tuft acro-osteolysis/calcinosis suffered from more severe disease. Arthropathies were infrequently detected and mainly consisted of a mixture of osteoarthritis-related changes (joint space narrowing and surface erosions)-also observed in controls-and of 2 types of rare SSc-associated arthropathies: a rheumatoid arthritis-like pattern, characterized by marginal erosions (n = 7 patients), and a collapse arthropathy (n = 6 patients), characterized by pressure erosions and joint subluxation.


CONCLUSIONS
Although a rheumatoid arthritis-like or a collapse arthropathy can be observed in SSc patients, arthropathies are less common than previously reported.
Koutaissoff
Sophie
S
Radiology Department, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium.
Vanthuyne
Marie
M
Smith
Vanessa
V
De Langhe
Ellen
E
Depresseux
Geneviève
G
Westhovens
Rene
R
De Keyser
Filip
F
Malghem
Jacques
J
Houssiau
Frédéric A
FA
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging / Q000503:physiopathology; D002114:Calcinosis / Q000000981:diagnostic imaging / Q000503:physiopathology; D016022:Case-Control Studies; D005260:Female; D006225:Hand / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000000981:diagnostic imaging / Q000503:physiopathology; D010014:Osteolysis / Q000000981:diagnostic imaging / Q000503:physiopathology; D011859:Radiography; D012595:Scleroderma, Systemic / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D012720:Severity of Illness Index; D055815:Young Adult