Arthritis in scleroderma.

Thirty-four patients (24 females and 10 males) selected from 300 consecutive patients with established systemic sclerosis (SSc), with a current or past history of articular symptoms, were clinically documented and further studied using thermography and bone scan to define the pattern of arthritis. Clinical evidence of synovitis was observed in 30 (88%) and joint inflammation was detected in 31 (91%) by the above-mentioned imaging techniques. A distinctive subset of 10 patients with deforming arthritis was characterized in which seven (70%) patients fulfilled criteria for both rheumatoid arthritis and SSC; three of these satisfied the criteria for diagnosis of CREST, but none met the criteria of mixed connective tissue disease. These patients, as a group, when compared with the rest showed limited skin involvement (skin score of 19 +/- 11 vs 33 +/- 14; P < 0.05) and were positive for rheumatoid factor (80 vs 13%; P < 0.05) and anticentromere antibodies (37 vs 4%; P < 0.05).