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Updated: Jun 10, 2026
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Published on: July 26, 2024
The thickness of the A1 pulleys reflects the disability of hand mobility in scleroderma. A pilot study using
Alberto Tagliafico1, Nicoletta Panico, Giovanni Serafini
1Department of Radiology, National Institute for Cancer Research, Genova, Italy. atagliafico@sirm.org
Background:
Hand involvement in scleroderma is a serious concern. Clinical tests to asses hand dysfunction are based on the experience of the clinician.
Objective:
To asses if utrasonographic (US) measurement of A1 pulley thickness may be used as an indicator of hand mobility in scleroderma.
Materials And Methods:
Institutional review board approval and patient informed consent was obtained. Twenty-eight patients affected suffering from scleroderma and 40 healthy controls were prospectively evaluated by two blinded radiologists with US, with a transducer operating at 17MHz. A1 pulley thickness was measured and correlated with the Hand Mobility in Scleroderma Test (HAMIS) and disease duration.
Results:
The thickness of the A1 pulley was greater in sclerodermic patients than in controls (p < 0.05). Intra and inter-observer agreement were better for ultrasound (0.94;0.88) than for HAMIS tests (0.71;0.70). A good correlation between pulley thickness, hand mobility and disease duration was found (r = 0.78, p < 0.018; r = 0.54, p < 0.05).
Conclusion:
A1 pulley thickness measured on ultrasound correlates with hand mobility and disease duration. Ultrasound is an useful tool to evaluate hand disability in scleroderma.
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