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Subcutaneous bursitis in scleroderma.

A Laganà1, J J Canoso

  • 1Rheumatology Section, New England Medical Center, Boston, MA 02111.

The Journal of Rheumatology
|October 1, 1992
PubMed
Summary
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Scleroderma patients can develop three types of subcutaneous bursitis. Septic bursitis, a serious complication, occurred in 15% of patients, often involving multiple bursae and leading to fistulas.

Area of Science:

  • Rheumatology
  • Dermatology
  • Infectious Diseases

Background:

  • Subcutaneous bursitis is a recognized complication in patients with scleroderma.
  • Understanding the different types and clinical presentations of bursitis is crucial for patient management.

Purpose of the Study:

  • To classify and describe the clinical characteristics of subcutaneous bursitis in patients with scleroderma.
  • To identify the incidence and complications of septic bursitis in this patient cohort.

Main Methods:

  • Retrospective review of 40 consecutive patients with scleroderma.
  • Clinical evaluation and diagnostic workup for subcutaneous bursitis, including polarizing microscopy and microbial cultures.
  • Classification of bursitis into dry, sterile, and septic types.

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Main Results:

  • Three types of subcutaneous bursitis were identified: dry, sterile (inflammatory effusions), and septic (Staphylococcus).
  • Septic bursitis occurred in 6 out of 40 patients (15%).
  • Septic bursitis presented with a protracted course, frequent fistulas, and multifocal involvement, especially in patients with extensive calcinosis.

Conclusions:

  • Subcutaneous bursitis is a heterogeneous condition in scleroderma patients.
  • Septic bursitis is a significant complication associated with poor outcomes, including fistulas and widespread involvement.
  • Early recognition and management of septic bursitis are essential in patients with scleroderma, particularly those with calcinosis.