Background The prevalence of arthritis in systemic sclerosis is unclear. Classically, arthritis is attributed to overlapping rheumatoid arthritis.
Objectives To assess the prevalence of and characterise arthritis in hands of patients with systemic sclerosis, excluding patients with overlapping arthritis forms.
Methods Low field MRI was performed in consecutive out- and inpatients with systemic sclerosis between January 2010 and March 2011. Results were assessed in a standardised manner summarised in the SCLERART score.
Results Of 38 inpatients and 8 outpatients, 30 participated. Of 26 patients that could be evaluated, erosions, bone marrow edema, synovitis, and effusions were found in 85%, 36%, 63%, and 56% respectively. 25% of patients had tenovaginitis. Arthritis affected only a few joints per hand analysed. While almost all bones could be affected, synovitis and bone marrow edema occurred most frequently the proximal row of carpal bones, most prominently the os lunatum. The amount of inflammatory changes measured with the SCLEART score correlated significantly with the functional status assessed with the Funktionsfragebogen Hannover FFbH.
Conclusions Arthritis is a frequent feature in patients with pure systemic sclerosis. The distribution and the MRI characteristics suggest that it may be caused more by ischemic mechanisms than by immunological inflammation.
Disclosure of Interest None Declared
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