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Radiological hand involvement in systemic sclerosis.

J Avouac1, H Guerini, J Wipff

  • 1Service de rhumatologie A, Hôpital Cochin, 27 rue du faubourg Saint Jacques, 75014 Paris, France.

Annals of the Rheumatic Diseases
|January 18, 2006
PubMed
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Systemic sclerosis (SSc) can affect hand structures, leading to disability. Radiological findings like flexion contracture and calcinosis are linked to disease subtypes and vascular complications.

Area of Science:

  • Rheumatology
  • Radiology
  • Systemic Autoimmune Diseases

Background:

  • Systemic sclerosis (SSc) frequently involves osteoarticular and soft tissues of the hand.
  • This involvement can lead to significant functional disability for patients.

Purpose of the Study:

  • To evaluate the specific radiological features of hands in patients with systemic sclerosis (SSc).
  • To compare these findings with those in control groups, including patients with rheumatoid arthritis and digital trauma.

Main Methods:

  • A cross-sectional study involving systematic hand radiology assessments.
  • 120 consecutive SSc patients and 42 controls (rheumatoid arthritis or digital trauma) were analyzed.
  • Radiological assessments were performed by two independent, blinded investigators.

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Main Results:

  • Common SSc hand abnormalities included erosion (21%), joint space narrowing (28%), arthritis (18%), demineralization (23%), acro-osteolysis (22%), flexion contracture (27%), and calcinosis (23%).
  • Distal phalange resorption correlated with digital ulcers, calcification, and pulmonary hypertension.
  • Flexion contracture was linked to diffuse cutaneous SSc and higher Health Assessment Questionnaire (HAQ) scores.

Conclusions:

  • Flexion contracture in diffuse cutaneous SSc contributes to disability and fibrosis.
  • Calcinosis and acro-osteolysis are associated with vascular complications, suggesting a role for vascular injury.