Authors: Rasha A AbdelMagied A Lotfi Ehab A AbdelGawad
Publish Date: 2013/01/25
Volume: 33, Issue: 8, Pages: 1961-1966
Abstract
The aim of the study was the detection of inflammatory arthropathy in patients with systemic sclerosis SSc with arthralgia using musculoskeletal ultrasonography MSUS and magnetic resonance imaging MRI and to compare between MRI versus MSUS detecting musculoskeletal abnormalities and find out its relation with other clinical and laboratory parameters Sixteen SSc patients with hand arthralgia had a baseline MSUS for their hands Six months later patients had a second MSUS and MRI with gadolinium of their most symptomatic hand Of the 16 patients examined by MSUS it was found that on baseline and second examination tenosynovitis was seen in 8 50 and 7 437 patients and synovitis was seen in 4 25 and 5 31 patients respectively indicating persistence synovial inflammation and erosion was seen in only 1 63 patient on baseline and second examination Regarding MRI 813 13 patients had tenosynovitis 875 14 patients had synovitis and 625 10 patients had erosions Applying the RAMRIS system a semiquantitative MRI scoring system used in RA the mean values for synovitis bone marrow edema and erosions fell within the range seen in RA Systemic sclerosis patients with arthralgia that have no obvious clinical inflammatory arthritis were found to have persistent inflammatory erosive arthropathy in their hands and wrists using MSUS and MRI While both MRI and MSUS are useful in characterizing synovial inflammation in SSc MRI is clearly more sensitive than MSUS in this setting Further studies on larger number of SSc patients with arthralgia and a control group consisting of SSc patients without arthralgia to better establish the clinical and radiological findings in SScSystemic sclerosis SSc scleroderma is a chronic disorder of connective tissue characterized by inflammation fibrosis and degenerative changes in the blood vessels skin synovium skeletal muscle and multiple internal organs The clinical features organ system involvement natural history and survival among patients with SSc are highly variable and largely depend on SSc clinical subtype and SScassociated serum autoantibodies 1 The musculoskeletal findings in progressive systemic sclerosis have been the subject of continued controversy partly because most reports describe mixed populations of SSc mixed connective tissue disease MCTD overlap syndromes of several connective tissue diseases and calcinosis Raynaud’s phenomenon esophageal dysmotility sclerodactyly and telangiectasia CREST patients 2
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