ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 017

High-Frequency Ultrasound Evaluation Predicts Disease Activity in Juvenile Localized Scleroderma

DANIELA GERENT PETRY PIOTTO1, Ana Sakamoto2, Rosangela Alves3, Gleice Clemente4, Melissa Fraga5 and Maria Teresa Terreri6, 1Universidade Federal de So Paulo, So Paulo, Brazil, 2Federal University of So Paulo (UNIFESP), So Paulo, Brazil, 3UNIFESP/ EPM, Sao Paulo, Sao Paulo, Brazil, 4Universidade Federal de Sao Paulo, So Paulo, Brazil, 5Universidade Federal de So Paulo, So Paulo, So Paulo, Brazil, 6UNIFESP, So Paulo, So Paulo, Brazil

Meeting: 2026 Pediatric Rheumatology Symposium

Session Information

Date: Thursday, March 19, 2026

Title: Abstracts: Imaging

Session Time: 5:29PM-5:34PM

Background/Purpose: Juvenile localized scleroderma (JLS) poses a diagnostic challenge due to its variable course and absence of standardized imaging biomarkers. High-frequency ultrasound (HFUS) allows objective assessment of cutaneous and subcutaneous inflammation and may help identify predictors of disease activity. This prospective study evaluates the role of HFUS in assessing JLS and determining clinical and ultrasonographic predictors of disease activity in patients with JLS.

Methods: Thirty-six JLS patients (63.8% female, mean age 13.1 ± 4.5 years) underwent HFUS (22 MHz) at baseline and one-year follow-up. Clinical activity was assessed using the Localized Scleroderma Cutaneous Assessment Tool (LoSCAT), Physician and Patient Global Assessments (PGA), and Modified Rodnan Skin Score (mRSS). HFUS parameters (dermal thickness, echogenicity, Power Doppler-PD) were measured in 229 images. Associations were analyzed between HFUS activity and individual LoSCAT features (erythema, new lesion, mRSS), with odds ratios (OR) and p-values reported. Logistic regression identified independent predictors of HFUS-defined activity.

Results: Active lesions exhibited increased dermal thickness (p < 0.001), reduced echogenicity (p < 0.001), and PD positivity (p < 0.001). HFUS activity was correlated strongly with LoSCAT activity (p < 0.001) and mRSS (p = 0.007). Erythema (OR 4.7, 95% CI 1.1–20.8, p = 0.039), new lesion formation (OR 26.8, 95% CI 2.1–339.0, p = 0.011), and skin thickening classified as lesions with mRSS ≥ 2 (OR 3.8, 95% CI 1.2–11.4, p = 0.020) were independent clinical predictors of HFUS activity. Over one year follow-up, dermal thickness and PD signal decreased in parallel with clinical improvement.

Conclusion: HFUS findings of increased dermal thickness, reduced echogenicity, and PD positivity are correlated with clinical features of erythema, new lesion formation, and skin thickening as key predictors of disease activity in JLS. B-mode parameters outperform clinical indices in detecting subclinical inflammation and monitoring therapeutic response, supporting HFUS as a sensitive and reproducible imaging biomarker for JLS.

Disclosures: D. PIOTTO: None; A. Sakamoto: None; R. Alves: None; G. Clemente: None; M. Fraga: None; M. Terreri: None.

To cite this abstract in AMA style:

PIOTTO D, Sakamoto A, Alves R, Clemente G, Fraga M, Terreri M. High-Frequency Ultrasound Evaluation Predicts Disease Activity in Juvenile Localized Scleroderma [abstract]. Arthritis Rheumatol. 2026; 78 (suppl 3). https://acrabstracts.org/abstract/high-frequency-ultrasound-evaluation-predicts-disease-activity-in-juvenile-localized-scleroderma/. Accessed .

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/high-frequency-ultrasound-evaluation-predicts-disease-activity-in-juvenile-localized-scleroderma/