AB0681 SCLERODERMIC HAND: SUBCLINICAL JOINT INVOLVEMENT?

Abstract

Background Systemic sclerosis (SSc) is a chronic autoimmune connective tissue disorder of not fully understood aetiology characterized by vascular and fibrotic abnormalities in the skin and internal organs. Musculoskeletal involvement, mainly affecting hands and feet, is frequent in SSc and represents a major cause of disability. Ultrasonography is a non-invasive, cost-effective imaging modality which is able to detect the presence of joint involvement in SSc. Methods 61 consecutive patients (60 women) were enrolled. Each patient has completed a dichotomous survey to evaluate the presence of joint symptoms (presence of pain, swelling, morning stiffness in the last 3 months). Subsequently a rheumatologist - blinded to clinical data and survey results - performed the ultrasound examination of hands and wrists to evaluate the presence of effusion, synovial hypertrophy, power-Doppler signal, erosions and tenosynovitis defined according to the OMERACT definitions. The ultrasound examination was performed using the Esaote MyLab70 with a multifrequency linear probe (6-18 MHz). Results Of the 61 patients analyzed, 29 showned joint involvement on the ultrasound examination (47.54%), in particular, 37.93% had tendon involvement and 72.41% joint involvement (Table 1). 31 patients did not report joint symptoms (50.82%) but 13 (41.93%) still had ultrasound alterations (Table 2). Conclusion Musculoskeletal involvement is frequent in SSc and can be asymptomatic in more than 20% of patients. The ultrasound examination can make it possible to detect articular and periarticular involvement at an early stage of the disease before the onset of disability. Disclosure of interests Laura Belloli: None declared, Cinzia Casu: None declared, Mariaeva Romano Speakers bureau: janssen, Elisa Verduci: None declared, Maria Di Cicco: None declared, Emanuela Schito: None declared, Valeria Campanella: None declared, Michel Chevallard: None declared, Marina Muscara: None declared, Davide antonio Filippini: None declared, Oscar Massimiliano Epis Speakers bureau: BMS