title: Ultrasonographic hand features in systemic sclerosis and correlates with clinical, biologic, and radiographic findings.
abstract: OBJECTIVE
  To investigate ultrasonographic (US) hand features in systemic sclerosis (SSc) patients and their relationship with clinical, biologic, and radiographic data.
  
  
  METHODS
  Fifty-two consecutive SSc patients were included in a cross-sectional observational study together with 24 rheumatoid arthritis (RA) patients enrolled as controls. All patients underwent clinical examination, including tender and swollen joint counts, measurement of disability indices, and hand/wrist radiographs. US was performed on the hand and wrist joints and was aimed at the detection of synovitis, tenosynovitis, and calcinosis.
  
  
  RESULTS
  Synovitis and tenosynovitis were more frequently detected with US in SSc patients (46% and 27%, respectively) than with clinical examination (15% and 6%, respectively; P < 0.01 for both comparisons). Fifty-seven percent of patients had inflammatory synovitis (mostly Doppler grade 1), and tenosynovitis was either inflammatory or fibrotic. Calcifications were observed using US and radiographs in 40% and 36% of SSc patients, respectively (P = 0.8). As compared to RA, US features specific to SSc were sclerosing tenosynovitis (P < 0.01) and soft tissue calcifications (P = 0.01).
  
  
  CONCLUSIONS
  Our study confirms that articular involvement in SSc is underestimated by a single clinical examination. It is characterized by mild inflammatory changes and the specific findings include sclerotic US aspects together with calcinosis. Further prospective studies are warranted to evaluate the predictive value of these findings and determine whether they should be considered for adapting a therapeutic strategy.
authors.affiliation: Paris Descartes University, Sorbonne Paris Cité, Cochin Hospital, AP-HP, France.
authors.forename: Muriel
authors.initials: M
authors.lastname: Elhai
authors.forename: Henri
authors.initials: H
authors.lastname: Guerini
authors.forename: Ramin
authors.initials: R
authors.lastname: Bazeli
authors.forename: Jerôme
authors.initials: J
authors.lastname: Avouac
authors.forename: Véronique
authors.initials: V
authors.lastname: Freire
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Drapé
authors.forename: André
authors.initials: A
authors.lastname: Kahan
authors.forename: Yannick
authors.initials: Y
authors.lastname: Allanore
mesh_terms: D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000175:diagnosis / Q000000981:diagnostic imaging*; D003430:Cross-Sectional Studies; D003937:Diagnosis, Differential; D005260:Female; D006225:Hand / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012595:Scleroderma, Systemic / Q000175:diagnosis / Q000000981:diagnostic imaging*; D013585:Synovitis / Q000175:diagnosis / Q000000981:diagnostic imaging; D013717:Tenosynovitis / Q000175:diagnosis / Q000000981:diagnostic imaging; D014463:Ultrasonography