OBJECTIVE: To explore the role of whole-body magnetic resonance imaging (MRI) in detecting musculoskeletal involvement in patients with systemic scleroderma and musculoskeletal symptoms. METHODS: Eighteen consecutive patients (8 men, 10 women) with systemic scleroderma (median age 46 years) presenting with musculoskeletal complaints underwent whole-body MRI at 1.5 T. Images were evaluated for abnormal signal intensity and/or thickening of subcutaneous fatty tissue septa, muscular fasciae, intramuscular perifascial septa, muscle signal intensity and articular or tendon sheath synovial abnormalities on STIR and post-gadolinium scans. Additionally, C-reactive protein, creatinine kinase and the modified Rodnan skin score were determined. RESULTS: MRI indicated evidence of fasciitis, articular synovial inflammation, and subcutaneous thickening in 16 (89 %) patients. MRI findings were compatible with myopathy or myositis in 14 (78 %) patients, tenosynovitis in 11 (61 %) patients and enthesitis in 10 (56 %) patients. Typically, these manifestations were distributed symmetrically and mostly generalised. We only found few correlations with modified Rodnan skin score, C-reactive protein and creatinine kinase. CONCLUSION: In patients with systemic scleroderma experiencing musculoskeletal symptoms, whole-body MRI is able to detect involvement of muscles, fasciae, joints and entheses more confidently compared with clinical and laboratory parameters.
OBJECTIVE: To explore the role of whole-body magnetic resonance imaging (MRI) in detecting musculoskeletal involvement in patients with systemic scleroderma and musculoskeletal symptoms. METHODS: Eighteen consecutive patients (8 men, 10 women) with systemic scleroderma (median age 46 years) presenting with musculoskeletal complaints underwent whole-body MRI at 1.5 T. Images were evaluated for abnormal signal intensity and/or thickening of subcutaneous fatty tissue septa, muscular fasciae, intramuscular perifascial septa, muscle signal intensity and articular or tendon sheath synovial abnormalities on STIR and post-gadolinium scans. Additionally, C-reactive protein, creatinine kinase and the modified Rodnan skin score were determined. RESULTS: MRI indicated evidence of fasciitis, articular synovial inflammation, and subcutaneous thickening in 16 (89 %) patients. MRI findings were compatible with myopathy or myositis in 14 (78 %) patients, tenosynovitis in 11 (61 %) patients and enthesitis in 10 (56 %) patients. Typically, these manifestations were distributed symmetrically and mostly generalised. We only found few correlations with modified Rodnan skin score, C-reactive protein and creatinine kinase. CONCLUSION: In patients with systemic scleroderma experiencing musculoskeletal symptoms, whole-body MRI is able to detect involvement of muscles, fasciae, joints and entheses more confidently compared with clinical and laboratory parameters.
Authors: Puja P Khanna; Daniel E Furst; Philip J Clements; Paul Maranian; Lilavati Indulkar; Dinesh Khanna Journal: Rheumatology (Oxford) Date: 2010-02-09 Impact factor: 7.580
Authors: P J Clements; P A Lachenbruch; J R Seibold; B Zee; V D Steen; P Brennan; A J Silman; N Allegar; J Varga; M Massa Journal: J Rheumatol Date: 1993-11 Impact factor: 4.666
Authors: L G Hanitsch; G-R Burmester; C Witt; N Hunzelmann; E Genth; T Krieg; W Lehmacher; I Melchers; M Meurer; U Müller-Ladner; E Schulze-Lohoff; M Becker; C Sunderkoetter; G Riemekasten Journal: Rheumatology (Oxford) Date: 2009-01 Impact factor: 7.580
Authors: Karin A L Mueller; Iris I Mueller; David Eppler; Christine S Zuern; Peter Seizer; Ulrich Kramer; Ina Koetter; Martin Roecken; Reinhard Kandolf; Meinrad Gawaz; Tobias Geisler; Joerg C Henes; Karin Klingel Journal: PLoS One Date: 2015-05-12 Impact factor: 3.240