Background Joint involvement is frequent finding and correlate with poor life quality in systemic sclerosis (SSc). MRI is a useful method for detection and quantification of inflammatory lesions of the hand (bone oedema, erosions, synovitis, tenosynovitis) in SSc patients.
Objectives In order to clarify the reported association between joint involvement (synovitis, tendon friction rubs, joint contracture) and clinical and/or laboratory features, it was decided to evaluate a group of pts with SSc.
Methods A total of 82 SSc pts (mean age 54y) were included in a study. All the patients were investigated for clinical and serological subset, disease duration, vascular, skin, joint, tendon, muscle, oesophagogastrointestinal, heart, lung and kidney involvement, diseaseactivity and HAQ-DI Index. MRI (contrast enhanced) low field MRI of the wrist the 2nd-5th metacarpophalangeal joints of the dominant hand were obtained. MRI were scored by 2 independent, blinded readers using the OMERACT RA scoring system for assessment bone marrow oedema, synovitis, bone erosions and tenosynovitis.Data were statistically analysed using Chi-square and the Students T test. A univariate step-wise logistic regression analysis was also performed for all variables identified with p<0,01. p<0,05 was considered statistically significant
Results Of 82 SSc pts 17,1% had clinical arthritis (14/82). Inflammatory MR findings with synovitis we found in 64/82 (78%)pts, MRI erosions in 52 (62,4%) or tenosynovitis in 11/82 (14,1%). Synovitis was more frequently detected on MRI (78%) than clinically (17,1%, p<0,001.We found that clinical arthritis of the hand was associated with joint contracture (probability for the occurrence of joint contractures was higher for the SSc pts with clinical arthritis- OR=4.64;95%CI 1,37-15,64; p<0,01), with HAQ>1,5 (OR=4.03;95%CI 1,14-14,21,p<0,03), with elevated sPAP>40mmHg (OR=8.62;95%CI 1,23-60,03;p<0,04), muscle weakness (OR=9.00;95%CI 1,34-60,15, p<0,03).It was also associated with elevated acute-phase reactants (OR=39,0;95%CI;474-320,62,p<0,001).
Conclusions Arthritis is a common finding in SSc even independent of clinical symptoms and signs. Our data show that arthritis is associated with a more severe disease and with systemic inflammation. This data support the use of MRI in clinical practice for early identification of SSc pts who will develop more severe disease with systemic inflammation
Disclosure of Interest None declared
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