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Assessment of the Cardiovascular System III: Palpation

Assessment of the Cardiovascular System III: Palpation

Palpation involves feeling the body to evaluate texture, size, consistency, and tenderness for assessing cardiovascular health. The following steps are organized in a head-to-toe order:
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Position the patient at a thirty- to forty-five-degree angle or in a semi-fowler's position. Look for the highest point of pulsation in the internal jugular vein and measure the vertical distance to the angle of Loius or sternal angle. A normal JVP is 3-4 cm above the...

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Head and Neck

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Updated: May 27, 2026

Imaging Features of Systemic Sclerosis-Associated Interstitial Lung Disease

Imaging Features of Systemic Sclerosis-Associated Interstitial Lung Disease

Published on: June 16, 2020

Evaluating hand in systemic sclerosis.

Didem Arslan Tas¹, Eren Erken, Hakan Sakalli

¹Faculty of Medicine, Cukurova University, Adana, Turkey. arslan_didem@yahoo.com

Rheumatology International

|November 18, 2011

Summary

Hand arthropathy in Systemic Sclerosis (SSc) is challenging. Radiography with rheumatoid factor (RF) and anti-CCP tests helps distinguish SSc arthropathy from rheumatoid arthritis (RA) overlap, guiding patient care.

Area of Science:

Rheumatology
Immunology
Radiology

Background:

Articular symptoms, particularly hand involvement, are frequent in Systemic Sclerosis (SSc).
Distinguishing SSc-related hand arthropathy from rheumatoid arthritis (RA) overlap is clinically challenging.
Understanding the nature of hand arthropathy in SSc is crucial for accurate diagnosis and management.

Purpose of the Study:

To identify key features differentiating SSc-associated hand arthropathy from RA-SSc overlap.
To assess the utility of serological tests and radiographic findings in this differentiation.

Main Methods:

Retrospective analysis of 28 SSc patients and 43 controls (21 RA, 22 healthy).
Assessment of serological markers (anti-CCP antibody, RF), hand radiography, finger-to-palm distance, and clinical features.

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Evaluation of disease activity and functional scores.

Main Results:

SSc patients showed distinct radiographic findings including erosions, joint space narrowing, demineralization, acro-osteolysis, and contractures.
Rheumatoid factor (RF) and anti-CCP positivity were significantly lower in SSc compared to RA.
Two SSc patients (7.14%) met criteria for RA overlap (positive RF/anti-CCP, arthritis on radiographs).
Seventeen SSc patients (61%) had SSc arthropathy (negative RF/anti-CCP, non-arthritic radiographic findings).
Arthritis correlated with heart involvement; finger-to-palm distance correlated with lung involvement in SSc.

Conclusions:

Hand radiography combined with RF and anti-CCP testing is valuable for discriminating SSc arthropathy from RA-SSc overlap.
Identifying hand arthropathy in SSc warrants increased attention to potential internal organ involvement.
This approach aids in precise diagnosis and management strategies for SSc patients with hand complaints.