Imaging Helps Guide Physical Therapy Treatment in a Patient With Diffuse Systemic Sclerosis (Scleroderma)

Area of Science:

• Rheumatology
• Orthopedics
• Physical Therapy

Background:

• Systemic sclerosis (scleroderma) can cause decreased finger range of motion and pain, impacting daily activities.
• Physical therapy is often recommended for managing functional limitations in patients with scleroderma.

Purpose of the Study:

• To determine the appropriateness of joint mobilization for a patient with systemic sclerosis and significant bone changes.
• To assess if joint mobilization could safely improve finger range of motion.

Main Methods:

• Radiographic imaging (posterior-to-anterior and modified lateral views) of both hands was performed.
• Evaluation of bone loss, calcinosis, and joint space narrowing in the phalanges and interphalangeal joints.
• Clinical assessment of finger range of motion and pain.

Main Results:

• Radiographs revealed significant bone loss in distal phalanges and calcinosis in the thumbs.
• Metacarpophalangeal and interphalangeal joint spaces were largely normal, with minimal narrowing in one joint.
• Joint mobilization was deemed appropriate due to the absence of severe joint destruction.

Conclusions:

• Joint mobilization can be considered a safe and appropriate intervention for improving finger range of motion in systemic sclerosis patients.
• Radiographic assessment is crucial to identify contraindications like severe joint destruction before initiating mobilization therapy.