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首页> 外文期刊>Joint, bone, spine : >The 'sclerodermic hand': a radiological and clinical study.
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The 'sclerodermic hand': a radiological and clinical study.

机译：“硬化性手”：放射学和临床研究。

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OBJECTIVE: To assess the clinical and radiographic features of hand involvement in patients with systemic sclerosis (SSc). METHODS: Forty-one unselected Sardinian SSc patients (32 women, 9 men; mean age 58.9, range 31-81 years; mean disease duration 11.8 years, range 1-36 years) were evaluated in this observational cross-sectional study. Twenty-six patients had diffuse scleroderma (dSSc) and 15 limited scleroderma (lSSc). Radiological examination of the hands was performed and the films were read by two independent rheumatologists blinded to the diagnosis using a classification system of four predefined radiological patterns (normal/minimal changes, articular degenerative, articular inflammatory and periarticular pattern). Correlations between radiological pattern, clinical and serological features were assessed. RESULTS: The skeletal and articular involvement of the hand was frequent in SSc, being clinically evident in 30/41 (73%) and radiologically in 33/41 (80%) of patients. The periarticular pattern (defined as the occurrence of bone resorption of ungueal tufts, soft tissue calcifications and/or flexion deformities) was the most frequent pattern detected (14/41, 34.1%) and finger flexion contractures and bone resorptions were significantly associated with interstitial lung disease, reduced FVC, oesophagus involvement and prostacycline therapy. Calcinosis (29.2%) was found to be associated with erosions, suggesting a pathogenic link. An inflammatory pattern was also radiologically frequent (8/41, 19.5%), but erosions, with the exception of those localized at distal interphalangeal joints, were demonstrated mainly in patients with clinical picture of rheumatoid arthritis overlapped with SSc. We found no significant differences in terms of radiographic findings between lSSc and dSSc with the exception of calcinosis, which was more frequent in patients with lSSc. CONCLUSION: This cross-sectional study confirms that the skeletal and articular involvement of the hand is frequent in SSc.
机译：目的：评估系统性硬化症（SSc）患者手部受累的临床和影像学特征。方法：本观察性横断面研究评估了41例未入选的撒丁岛SSc患者（32例女性，9例男性;平均年龄58.9，范围31-81岁;平均病程11.8年，范围1-36岁）。 26例患者患有弥漫性硬皮病（dSSc）和15例有限性硬皮病（lSSc）。对手进行了放射学检查，并由两名独立的风湿病学医师使用四种预定的放射学模式（正常/最小变化，关节退行性变，关节炎性和关节周围型）分类系统，对诊断不知情的人读取了胶片。放射线模式，临床和血清学特征之间的相关性进行了评估。结果：SSc中手的骨骼和关节受累频繁，在30/41（73％）和放射学上在33/41（80％）的患者中临床上很明显。关节周围模式（定义为出现不规则簇的骨吸收，软组织钙化和/或屈曲畸形）是最常见的模式（14 / 41，34.1％），手指屈曲挛缩和骨吸收与间质性显着相关肺部疾病，FVC降低，食道受累和前列环素治疗。发现钙化病（占29.2％）与侵蚀有关，表明存在致病联系。放射学上也很常见炎症模式（8 / 41，19.5％），但是糜烂，除了位于远端指间关节处的糜烂外，主要表现在类风湿关节炎与SSc重叠的临床患者中。我们发现，除了钙中毒，在lSSc和dSSc之间的影像学检查结果上无显着差异，而钙化病在lSSc患者中更为常见。结论：这项横断面研究证实，SSc中手的骨骼和关节受累频繁。

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