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Updated: Aug 9, 2025

Imaging Features of Systemic Sclerosis-Associated Interstitial Lung Disease

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Published on: June 16, 2020

Peripheral Macrovascular Involvement in Systemic Sclerosis: A Cohort Study by Color and Spectral Doppler

Roberto D'Alessandro¹, Estrella Garcia Gonzalez¹, Paolo Falsetti¹

¹Rheumatology Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy.

Life (Basel, Switzerland)

|February 25, 2023

Summary

Ulnar artery occlusions (UAOs) affect 28% of systemic sclerosis (SSc) patients, particularly those with interstitial lung disease and late nailfold-video-capillaroscopy patterns. Ultrasound can identify patients at risk for digital ulcers.

Keywords:

Raynaud phenomenon digital ulcer fibrosis resistance index systemic sclerosis ulnar artery ulnar artery occlusion ultrasonography vasculopathy

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Area of Science:

Rheumatology
Vascular Medicine
Diagnostic Imaging

Background:

Systemic sclerosis (SSc) is a connective tissue disease known for skin and organ sclerosis and small vessel issues.
Large vessel involvement, specifically ulnar artery vasculopathy, is an increasingly recognized feature in SSc patients.
Assessing macrovascular complications is crucial for managing SSc progression and patient outcomes.

Purpose of the Study:

To evaluate macrovascular involvement in systemic sclerosis (SSc) patients.
To assess radial and ulnar arteries using ultrasound (US).
To identify correlations between vascular findings and clinical features.

Main Methods:

Ultrasound (US) evaluation of radial and ulnar arteries in 43 SSc patients.
Measurement of resistance indices (RIs) and peak systolic velocity (PV).
Comparison with Raynaud phenomenon (RP) and healthy control (HC) groups, alongside clinical feature assessment.

Main Results:

Ulnar artery occlusions (UAOs) were found in 28% of SSc patients, often bilateral (75%) and associated with late nailfold-video-capillaroscopy (NVC) patterns (42%).
Patients with UAOs frequently experienced digital ulcers (DUs) (83.3%).
Lower radial and ulnar PVs and higher RIs were observed in SSc and RP patients compared to HC. Interstitial lung disease (ILD) and NVC pattern were key predictors of UAO.

Conclusions:

Ulnar artery occlusion (UAO) is a significant finding in severe SSc, linked to ILD and late NVC patterns.
Ultrasound-assessed RI may help differentiate SSc patients from healthy controls.
US is a valuable tool for identifying SSc patients at high risk for developing digital ulcers (DUs).