Background/objectives Systemic sclerosis (SSc) is an autoimmune disease associated with immune abnormalities and widespread vascular lesions, including increased intimal and medial thickness. These changes may be reflected in early atherosclerosis and cardiovascular risks. We aimed in this study to examine the carotid artery intima-media thickness and MRI brain findings in SSc patients and compared them to a group of normal controls. A relationship between these parameters and clinical measures in SSc was also sought. Methods Seventy-two SSc patients with no central nervous system (CNS) symptoms and 42 healthy controls were included. Clinical and laboratory measures, Medsger’s severity scale, and Doppler ultrasound common carotid artery intima-media thickness (CCA-IMT) were measured. Brain fluid-attenuated inversion recovery (FLAIR)-MRI and diffusion-weighted MRI (DWI) were also done. Results SSc patients had more CCA-IMT, higher CRP, and more brain MRI hyperintense lesions than controls ( P < 0.05). Significant positive correlations existed between CCA-IMT and Medsger vascular ( r = 0.7, P = 0.02). The FLAIR-MRI showed multiple hyperintense lesions in 24 patients (33%), ranging 0–36 lesions. SSc patients with more lesions (positive MRI) had longer disease duration ( P = 0.001) and left and right carotid artery atheromata ( P = 0.001, and 0.013, respectively) than SSc patients with negative MRIs; Medsger vascular score did not separate the SSc groups ( P = 0.08). Conclusions In systemic sclerosis patients without central nervous system symptoms, MRI lesion numbers correlated with CCA-IMT. MRI abnormalities were found more frequently if CRP was elevated, if the Medsger SSc Severity Scale was increased, or if there was thickened carotid IMT.

Background: Malignant otitis externa (MOE) is a potentially fatal disease; accurate assessment of the extent of this disease is warranted to plan the course of treatment and to predict the prognosis. The aim of the study was to compare the efficiency of high resolution computed tomography (HRCT) with that of 99m Three patients had petrous involvement reaching midline (stage III), 2 of them were surviving with clinical improvement, and the 3 rd patient died. Fourteen patients had sphenoid involvement/disease extended to the contralateral temporal bone (stage IV), 5 of them were surviving with recovery and clinical improvement, 5 were surviving, yet had disease progression, and 4 patients died within less than one year of diagnosis. At the end of follow up period; in total; 7 patients had died, of whom 3 in stage IV died due to MOE, while the remaining 4 cases (2 in stage II, 1 in stage III, and 1 in stage IV) died due to unrelated causes. Both of disease duration and SPECT/CT staging were statistically significant predictor factors for DFS (P=0.05 and 0.047 respectively). Conclusion:SPECT/CT has a higher sensitivity than HRCT in determining the exact extent of MOE and was much better correlated with disease prognosis.

Scientific AbstractsFriday, 12 June 2015 645visualized 3D Doppler findings in relation to the tendon sheath were plotted on a schematic drawing ( Fig. 1A and 1B). Results: The overall distribution of feeding vessels was comparable at the level of Lister's tubercle and the level at the pisiforme for the extensor tendons. For the flexor tendons, feeding vessels were more frequent at the level of Lister's tubercle, as shown in Fig. 1A and 1B. Overall feeding vessels were less frequent for compartment V and VI at the level of Lister's tubercle. Feeding vessels were seen less at the superficial location for the extensor tendons, except for compartment I. Radial and dorsal vessels were rare in the tendon sheath of flexor digitorum superficialis and profundus. Intertendineus feeding vessels were mainly seen in the tendon sheath of flexor digitorum superficialis and profundus. Conclusions: Feeding vessels in close relation to the extensor and flexor tendon sheaths were common in the wrist of healthy participants and may be a cause of misinterpretation due to artefacts. These vessels should be taken into consideration when diagnosing tenosynovitis in the wrist. References: [1] Terslev L, Torp-Pedersen S, Qvistgaard E, von der Recke P, Bliddal H. Doppler ultrasound findings in healthy wrists and finger joints. Ann Rheum Dis. 2004 [2] Lillegraven S, Boyesen P, Hammer HB, Ostergaard M, Uhlig T, Sesseng S, et al. Tenosynovitis of the extensor carpi ulnaris tendon predicts erosive progression in early rheumatoid arthritis. Ann Rheum Dis. 2011 [3] Torp-Pedersen ST, Terslev L. Settings and artefacts relevant in colour/power Doppler ultrasound in rheumatology. Ann Rheum Dis. 2008

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