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Skeletal Radiology

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01-01-2005 | Article

The arthropathy of systemic sclerosis: a 12 month prospective clinical and imaging study

Authors: Giovanni La Montagna, Antonio Sodano, Vittorio Capurro, Domenico Malesci, Gabriele Valentini

Published in: Skeletal Radiology | Issue 1/2005

Abstract

Objective

To assess the clinical and radiological features of systemic sclerosis (SSc) joint involvement in a prospective cross-sectional study.

Design and patients

Seventy-six consecutive patients with SSc divided into clinical and serological subsets were investigated. Clinical and radiological assessments of the hands and feet were carried out. Three radiological patterns of inflammatory, degenerative and fibrotic changes were predefined. The Health Assessment Questionnaire (HAQ) disability index (DI) and individual components of the HAQ-DI were also evaluated.

Results

The highest impairments on the HAQ-DI (median 0.44; range 0–2.87) were detected in subdimensions such as hygiene, grip and activity components. Clinically articular involvement, arthralgia and finger contractures were seen more frequently than arthritis, and a significantly higher prevalence of finger flexion was found in patients with diffuse cutaneous SSc (P=0.03) compared with the other SSc subtypes. Radiologically, distal interphalangeal joint space narrowing and flexion deformity indicating periarticular fibrosis were frequently detected. Juxta-articular osteoporosis, joint space narrowing and flexion contractures of the fingers were seen significantly more frequently in the hands. A significantly higher frequency of fibrotic pattern were found in the hands whereas a degenerative pattern was more frequent in the feet (P<0.05). Finally, significant correlations were detected between flexion contractures and a radiological fibrotic pattern (P<0.001), and the severity scores of peripheral vascular impairment (P=0.026) and skin (P=0.007).

Conclusion

This cross-sectional prospective study confirms that an arthropathy is common in SSc patients and shows that it is a major determinant of disability. A classification of radiological alterations into three specific patterns is proposed.

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Title: The arthropathy of systemic sclerosis: a 12 month prospective clinical and imaging study
Authors: Giovanni La Montagna
Antonio Sodano
Vittorio Capurro
Domenico Malesci
Gabriele Valentini
Publication date: 01-01-2005
Publisher: Springer-Verlag
Published in: Skeletal Radiology / Issue 1/2005
Print ISSN: 0364-2348
Electronic ISSN: 1432-2161
DOI: https://doi.org/10.1007/s00256-004-0830-6

At a glance: The STEP trials

Springer Medicine

The arthropathy of systemic sclerosis: a 12 month prospective clinical and imaging study

Abstract

Objective

Design and patients

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Objective

Design and patients

Results

Conclusion

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