title: Localized scleroderma: MR findings and clinical features.
abstract: OBJECTIVE
  To describe musculoskeletal manifestations seen at magnetic resonance (MR) imaging in patients with localized scleroderma (LS) and to examine the relationship of MR findings to clinical subtypes and clinically suspected musculoskeletal features.
  
  
  METHODS
  Institutional review board approval was obtained. Forty-three patients (30 female, 13 male; mean age, 42 years) with LS underwent MR imaging with a 1.5-T MR imager between November 2005 and June 2010. Findings were classified into clinical subtypes according to recently published consensus criteria. Images were evaluated for morphologic changes and signal abnormalities of subcutaneous fat septa, muscle fasciae, intramuscular septa, joint and/or tendon sheath synovia, entheses, and bone marrow. Clinically suspicious features of musculoskeletal manifestations-such as articular or periarticular pain, joint contractures, swelling, and increased warmth of the joints or extremities-were recorded.
  
  
  RESULTS
  Musculoskeletal involvement was detected with MR imaging in 32 (74%) of 43 patients. It was detected with MR imaging in 26 (96%) of 27 patients in whom it was clinically suspected and in six (38%) of 16 patients in whom it was not clinically suspected. We found fascial thickening (26 [60%] of 43 patients), increased fascial enhancement (23 [53%] of 43 patients), articular synovitis (17 [40%] of 43 patients), tenosynovitis (nine [21%] of 43 patients), perifascial enhancement (seven [16%] of 43 patients), myositis (six [14%] of 43 patients), enthesitis (three [7%] of 43 patients), bone marrow involvement (two [5%] of 43 patients), and subcutaneous septal thickening (28 [65%] of 43 patients). The highest prevalence of musculoskeletal involvement was seen in patients with pansclerotic morphea.
  
  
  CONCLUSIONS
  MR imaging reveals musculoskeletal involvement in patients with localized scleroderma.
authors.affiliation: Department of Dermatology, Eberhard-Karls-University Tübingen, Hoppe-Seyler-Str 3, 72076, Tübingen, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Schanz
authors.forename: Gerhard
authors.initials: G
authors.lastname: Fierlbeck
authors.forename: Anja
authors.initials: A
authors.lastname: Ulmer
authors.forename: Marc
authors.initials: M
authors.lastname: Schmalzing
authors.forename: Jasmin
authors.initials: J
authors.lastname: Kümmerle-Deschner
authors.forename: Claus D
authors.initials: CD
authors.lastname: Claussen
authors.forename: Marius
authors.initials: M
authors.lastname: Horger
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D045745:Scleroderma, Limited / Q000175:diagnosis*; D012680:Sensitivity and Specificity; D055815:Young Adult