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Joint Bone Spine
Sous presse. Epreuves corrigées par l'auteur. Disponible en ligne depuis le samedi 29 février 2020
Doi : 10.1016/j.jbspin.2020.01.011
accepted : 31 January 2020
Ultrasound prevalence of wrist, hand, ankle and foot synovitis and tenosynovitis in systemic sclerosis, and relationship with disease features and hand disability
 

Jason Hubac a, , Mélanie Gilson a, Philippe Gaudin a, b, Marine Clay a, Bernard Imbert c, Patrick Carpentier c
a Grenoble Alpes University Hospital, Hopital Sud, Rheumatology Department, CS 90338, 38434 Echirolles cedex, France 
b GREPI, AGIM UJF CNRS FRE 3405, 38706 La Tronche, France 
c Grenoble Alpes University Hospital, Hopital Michallon, Department of Vascular Medicine, CS 10217, 38043 Grenoble cedex 9, France 

Corresponding author.
Highlights

US was more sensitive than clinical examination to detect synovitis and tenosynovitis in SSc.
US foot involvement is less frequent than hand involvement but affects a quarter of the patients and is mostly located at MTP joints.
US hand synovitis seems associated with hand disability and DcSSc.
This is the first and largest US study investigating specifically foot's synovitis and tenosynovitis in SSc classified with ACR/EULAR 2013 criteria.

The full text of this article is available in PDF format.
Abstract
Introduction

In systemic sclerosis, few studies have shown that hand and wrist ultrasound is more sensitive than clinical examination in the detection of synovitis and tenosynovitis. Even fewer studies have investigated ankle and foot involvement with ultrasound. Our objectives were to investigate ultrasound prevalence of wrist, hand, ankle and foot synovitis and tenosynovitis in patients with systemic sclerosis classified with ACR/EULAR 2013 criteria, and to study their relationship with disease features and hand disability.

Methods

Consecutive patients with systemic sclerosis, classified with ACR/EULAR 2013 criteria, were included in a monocentric cross-sectional study. They underwent standardized musculoskeletal clinical examination and hand, wrist, ankle and foot ultrasound. Clinical, biological and imaging data were also collected.

Results

Fifty-five patients were included. Ultrasound was more sensitive than clinical examination to detect at least one synovitis (respectively 52% versus 25%, P =0.025) and at least one tenosynovitis (respectively 16% versus 4%, P =0.009); 18% of patients had ankle tenosynovitis and 29% had ankle and/or foot synovitis, mostly located at metatarsophalangeal joints (25.5%). Having at least one ultrasound hand synovitis was associated with higher Cochin hand functional disability scale (mean 25±3 versus 12±2, P =0.003) and diffuse cutaneous subset (P =0.038).

Conclusion

Our study shows that ultrasound is more sensitive than clinical examination to detect synovitis and tenosynovitis in systemic sclerosis. The foot involvement is less frequent than hand involvement, mainly localized at metatarsophalangeal joint. Finally, having at least one synovitis of the hand is associated with diffuse cutaneous subset and higher hand disability.

The full text of this article is available in PDF format.

Keywords : Ultrasound, Synovitis, Tenosynovitis, Systemic sclerosis, Disability




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