Photo Credit: Sopone Nawoot
The following is a summary of “Combined radiographic and ultrasound evaluations to decipher joint involvement in the hands of patients with systemic sclerosis,” published in the October 2024 issue of Rheumatology by Tas et al.
Researchers conducted a retrospective study to explore the etiologies and contributing factors of synovial and tenosynovial involvement in systemic sclerosis (SSc) and assess the phenotype of affected patients.
They included 171 patients with SSc and hand manifestations (vascular, skin, or joint) who underwent X-rays and hand ultrasound (US). Acro-osteolysis, calcinosis, microcrystalline, and degenerative rheumatisms on X-rays were recorded by 2 evaluators, while a third evaluator, blinded to X-ray findings, assessed synovitis and tenosynovitis (active or fibrotic) via ultrasound.
The results showed that multivariate analysis identified several characteristics associated with active synovitis and tenosynovitis, including CRP >10 mg/L (P = 0.013), fibrotic tenosynovitis on US (P = 0.005), anti-RNA polymerase III antibodies (P = 0.043), and poly-osteophytosis on hand X-rays (P = 0.001). After excluding patients with rheumatoid arthritis (n = 5) and/or poly-osteophytosis (n = 53), 14 remaining patients (12.7%) had active synovitis and tenosynovitis in the US. In this selected group, scleroderma renal crisis (P = 0.012) and fibrotic tenosynovitis in the US (P < 0.001) were associated with active synovitis and tenosynovitis.
The study concluded that osteophytosis significantly contributes to joint involvement in patients with systemic sclerosis (SSc), with over 10% exhibiting active synovitis and/or tenosynovitis on ultrasound, suggesting a specific SSc-related synovial involvement.
Source: academic.oup.com/rheumatology/advance-article-abstract/doi/10.1093/rheumatology/keae602/7849660
