The "sclerodermic hand": a radiological and clinical study

Area of Science:

• Rheumatology
• Radiology
• Scleroderma Research

Background:

• Systemic sclerosis (SSc) is a multisystem autoimmune disease characterized by ত্বক thickening and internal organ fibrosis.
• Hand involvement is a common manifestation of SSc, impacting patients' quality of life and function.
• Understanding the spectrum of hand involvement is crucial for comprehensive patient management.

Purpose of the Study:

• To characterize the clinical and radiographic features of hand involvement in patients with systemic sclerosis (SSc).
• To identify correlations between radiological patterns and clinical/serological features in SSc hand involvement.

Main Methods:

• Observational, cross-sectional study of 41 Sardinian SSc patients (32 female, 9 male; mean age 58.9 years).
• Radiological hand examinations were performed and interpreted by two independent, blinded rheumatologists using a four-pattern classification.
• Clinical and serological data were collected and correlated with radiographic findings.

Main Results:

• Skeletal and articular hand involvement was frequent: 73% clinically and 80% radiologically.
• The periarticular pattern (bone resorption, calcifications, flexion deformities) was most common (34.1%).
• Periarticular findings correlated with interstitial lung disease, reduced FVC, esophageal involvement, and prostacyclin therapy. Calcinosis (29.2%) associated with erosions. Inflammatory patterns were frequent, often with overlapping rheumatoid arthritis features. Calcinosis was more common in limited SSc (lSSc) than diffuse SSc (dSSc).

Conclusions:

• Hand skeletal and articular involvement is a frequent manifestation of systemic sclerosis (SSc).
• Specific radiological patterns, like periarticular changes, are associated with systemic complications and treatment.
• Radiographic findings in SSc hands provide valuable insights into disease phenotype and progression.