Background/Purpose: Musculoskeletal involvement is a major complication for patients with systemic sclerosis (SSc). Various radiographic abnormalities are observed, especially in hands, however, the detailed prevalence and the association with autoantibodies are still unclear. Our objective was to clarify the characteristics of radiographic findings in hand X-ray and their association with autoantibodies in SSc.

Methods: One hundred Japanese patients with SSc without rheumatoid arthritis were included. Two directional hand X-ray was examined to evaluate joint and soft-tissue changes. Clinical and serological parameters were collected retrospectively from medical records. The prevalence of abnormal findings in X-ray and the associations with clinical features, SSc subtypes and autoantibodies were analyzed.

Results: The mean age was 65.7 years (range 25-88 years), 89% were female and the mean disease duration was 11 years (range 1-44 years). Twenty-six patients (26%) were positive for anti-Scl-70 antibody, 54% for anti-centromere antibody, 6% for anti-RNA polymerase III antibody, and 6% for anti-U1RNP antibody. Twenty-four percent was diffuse cutaneous SSc and 76% was limited cutaneous SSc. Sixty one patients (61%) showed abnormality in hand X-ray; acroosteolysis in 16%, erosive disease in 20%, calcinosis in 14%, and flexion contracture in 8%. Clustering analysis for clinical features demonstrated that acroosteolysis, calcinosis and flexion contracture were associated with digital tip ulcer, interstitial lung disease and gastrointestinal involvement, but erosive disease was only associated with older age. Anti-Scl-70 was significantly associated with acroosteolysis (p<0.001) and anti U1-RNP with acroosteolysis and flexion contracture (p<0.05 for both) while anti-centromere was inclined to associate with calcinosis (p=0.08).

Conclusion: Abnormal findings in hand X-ray were observed more frequently in SSc patients with longer disease duration, disturbed peripheral circulation, and internal organ involvement. The type of autoantibodies was also associated with the radiographic findings. These results suggest that X-ray findings may reflect the underlying pathogenesis in SSc.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/association-of-radiographic-findings-in-hand-x-ray-with-autoantibodies-in-patients-with-systemic-sclerosis/