Ultrasound Evaluation of the Hands and Wrists in Patients with Systemic Sclerosis: Osteophytosis is a Major Contributor to Tender Joints
| Autor: | Audra Horomanski, Melody P. Chung, Khushboo Sheth, Laurel Sharpless, Shufeng Li, Jison Hong, Lorinda Chung, Robert Fairchild |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
musculoskeletal diseases
medicine.medical_specialty integumentary system business.industry Inflammatory arthritis Concordance Soft tissue pathology medicine.disease Gastroenterology Median nerve Article Anesthesiology and Pain Medicine Rheumatology Calcinosis Internal medicine Joint pain medicine.artery medicine medicine.symptom skin and connective tissue diseases business Ulnar artery Muscle contracture |
| Zdroj: | Semin Arthritis Rheum |
| Popis: | Objective To evaluate the prevalence and clinical associations of ultrasound (US) findings of inflammatory arthritis and joint and soft tissue pathology in patients with systemic sclerosis (SSc). Methods The hands and wrists of 43 SSc patients and 35 age-balanced controls were evaluated by clinical exam and musculoskeletal US. Synovial and tenosynovial pathology were assessed using semi-quantitative Gray Scale (GS) and Power Doppler (PD) scoring. US evaluation for osteophytes, erosions, ulnar artery occlusion, and median nerve cross-sectional areas was performed. Tender joints (TJ), swollen joints (SJ), modified Rodnan skin score (mRSS), digital ulcers, contractures, and calcinosis were evaluated. Concordance between US and physical exam findings at each joint region were assessed, and associations between their severity were analyzed. Results TJs and SJs were present in 44.2% and 62.8% of SSc patients, respectively. Inflammatory arthritis, defined as having both GS>0 and PD>0, was observed in 18.6% of SSc patients and no controls. There was a high concordance by joint region between GS synovial hypertrophy and osteophytes (κ=0.88) as well as TJs (κ=0.72). SSc patients had more osteophytes compared to controls (48.8% vs 22.9%, p = 0.018) as well as higher osteophyte severity (p = 0.033). Conclusions Despite a high percentage of tender and swollen joints, less than 20% of SSc patients met criteria for inflammatory arthritis on US. The high concordance of osteophytes with GS synovial hypertrophy and tender joints suggest that osteophytosis may be a significant contributor to joint pain in SSc patients. |
| Databáze: | OpenAIRE |
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