FRI0276 Peripheral Structural Evaluation (radiographic) and Axial (scan) in A Population of 77 Patients with Systemic Sclerosis
2016
Objectives The objective of this study was to describe for the first time the prevalence and characteristics of radiographic lesions of the hands and calcifications of the spine visible on CT scans (thoracic, thoracic-abdominal pelvic (TAP), and lumbar), in a population of patients with systemic sclerosis (SSc) (n=77) treated at the Nancy University Hospital (CHU) and to determine the relationships of these with the clinical and biological expression of the disease and its prognosis. Methods This was a single centre, retrospective, descriptive and analytical study involving 77 patients treated in the CHU for limited cutaneous SSc (lcSSc) or diffuse cutaneous SSc (dcSSc) complying with the ACR/EULAR 2013 classification criteria and having had an X-ray examination of the hands and a thoracic, TAP or lumbar CT scan within the same year. The X-ray evaluation of the hands was performed as described by Erre G.L et al. The morphological and topographical evaluation of the calcifications was performed on 3 spinal segments: discovertebral, intracanal and posterior. The prognostic factors were interstitial pulmonary lesions on the CT scan, pulmonary arterial hypertension (PAH) and death. Results Of the 77 patients of mean age 56.9 years (88.3% females), 55 (71%) suffered from lcSSc and 22 (29%) from dcSSc. There were statistically significantly more patients with interstitial disease on the CT scan and restrictive syndrome in the dcSSc group than in the lcSSc group. Study of the radiographic lesions revealed the following prevalences: calcinosis 26%, acro-osteolysis 20.8%, periarticular calcifications 28.6%, erosions 24.7%, narrowing 42.9%, subluxations 19.9% and flexion 27.3% of cases. Calcinosis, acro-osteolysis and periarticular calcifications were related to the duration of progression of the disease and to the onset of digital ulcers (DU) (p=0.002; p Conclusions This study shows for the first time, a link between peripheral periarticular calcifications and spinal calcifications detected on the CT scan. These results suggest that spinal calcifications could provide an indicator of severity and predict mortality in patients suffering from SSc. References Erre GL, Marongiu A, Fenu P, Faedda R, Masala A, Sanna M, et al. The “sclerodermic hand”: a radiological and clinical study. Jt Bone Spine Rev Rhum. 2008;75(4):426–31. Ogawa T, Ogura T, Ogawa K, et al. Paraspinal and intraspinal calcinosis: frequent complications in patients with systemic sclerosis. Ann Rheum Dis. 2009;68(10):1655–6. Disclosure of Interest None declared
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