MRI findings in deep and generalized morphea (localized scleroderma)

Area of Science:

• Radiology
• Dermatology
• Rheumatology

Background:

• Morphea is a rare connective tissue disorder characterized by localized fibrosis of the skin, subcutaneous tissue, fascia, and sometimes muscle.
• Deep and generalized morphea represent more extensive and severe forms of the disease, posing diagnostic and management challenges.

Purpose of the Study:

• To delineate the magnetic resonance imaging (MRI) characteristics observed in patients diagnosed with deep and generalized morphea.
• To correlate MRI findings with the known pathomorphologic changes of morphea.

Main Methods:

• Retrospective review of MRI examinations in patients with clinically and histopathologically confirmed deep and generalized morphea.
• Detailed analysis of imaging features, including signal intensity, enhancement patterns, and extent of involvement across different tissue layers.

Main Results:

• MRI demonstrates a spectrum of findings in morphea, reflecting fibrosis, inflammation, and edema.
• Common features include skin and subcutaneous thickening, fascial enhancement, and T2-weighted hypointensity, with potential muscle signal abnormalities.
• Imaging can delineate the depth of tissue infiltration and the extent of disease involvement.

Conclusions:

• While MRI findings in morphea are not pathognomonic and can overlap with other inflammatory and fibrotic conditions, they are crucial for assessing disease extent.
• MRI enables a comprehensive evaluation of morphea, including the depth of infiltration and assessment of disease activity, aiding in clinical management.
• Understanding these imaging features is vital for differentiating morphea from other fasciitis and myositis disorders.