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The radiographic changes of scleroderma in the hands
T Doyle1, G Littlejohn, M Miller
1Department of Radiology, Royal Melbourne Hospital.
Australasian Radiology
|February 1, 1990
Summary
Radiographs reveal scleroderma patients with distal calcinosis often have specific clinical and serological markers. Lack of distal calcinosis links to different antibody profiles, aiding disease understanding.
Area of Science:
- Rheumatology
- Radiology
- Immunology
Background:
- Scleroderma is a complex autoimmune disease characterized by fibrosis and vascular abnormalities.
- Radiological manifestations are common in scleroderma, but their correlation with clinical and serological features requires further elucidation.
- Calcinosis, a hallmark of scleroderma, can occur in different locations and may have distinct associations.
Purpose of the Study:
- To investigate the correlation between the location of calcinosis (distal vs. proximal to metacarpophalangeal joints) and specific clinical and serological characteristics in patients with scleroderma.
- To document the prevalence of other radiological findings in scleroderma.
- To enhance understanding of the heterogeneity of scleroderma manifestations.
Main Methods:
- Retrospective review of hand radiographs from 160 patients diagnosed with scleroderma.
- Analysis of the presence and location of calcinosis (distal or proximal to metacarpophalangeal joints).
- Correlation of radiological findings with clinical data (disease duration, digital ulceration, telangiectasia) and serological markers (anticentromere antibodies, anti-Scl 70, antinucleolar antibodies).
Main Results:
- Distal calcinosis was significantly associated with female sex, disease duration >10 years, digital ulceration, telangiectasia, tuft erosion, and anticentromere antibodies.
- Proximal calcinosis correlated with tuft erosions and erosions involving all joints.
- Absence of distal calcinosis was linked to anti-Scl 70 and antinucleolar antibodies.
- Prevalence of osteoarthritis, erosions, and dorsal tuft modelling was also documented.
Conclusions:
- Specific radiological findings, particularly the location of calcinosis, are significantly correlated with distinct clinical and serological profiles in scleroderma.
- These correlations can aid in a more nuanced understanding and potentially personalized management of scleroderma.
- Radiographic assessment provides valuable insights into the multifaceted nature of scleroderma.