Musculoskeletal Involvement in Systemic Sclerosis: An Unexplored Aspect of the Disease

Abstract

efficient therapy for this very important aspect of SSc affecting the majority of the patients. Articular involvement Joint involvement in SSc mainly affects the hands and leads to significant irreversible damage (5-10). In a Canadian self-administered online survey (11) of 464 SSc patients, complaints related to impaired hand function were reported by about three-quarters of the patients. More specifically, an impaired hand function included hand stiffness and joint pain in 81%, swollen joints in 61% of the cases. Physical examination by physicians in the EUSTAR cohort of 7286 SSc patients (3) showed an overall prevalence of arthritis (i.e., tender and swollen joints) in only 16% of the cases. The prevalence of joint contractures was 31% (3). In the diffuse (dc)SSc subset, the functional impairment is often rapid and early, appearing within the first 18 months after onset of the disease in about half of the patients (12). Joint involvement, including arthritis or arthralgia may be one of the very first disease symptoms, therefore it is important to screen each patient

Ventilation distribution as a contributor to the functional exercise capacity in patients with systemic sclerosis-associated interstitial lung disease without pulmonary hypertension

“…The differences in the results between the two studies might be partially explained by differences in the populations studied, because we excluded SSc-PH patients and those with extensive ILD on HRCT. Corroborating this hypothesis, an association between peripheral muscle dysfunction and reduced lung function has been previously described (11), and it reinforces the importance of studying the various SSc phenotypes individually.…”

“…Similar to cardiopulmonary involvement, skeletal muscle involvement in SSc may be an early indicator of an unfavorable prognosis (11). Due to the different criteria used to define muscle involvement in SSc, its real prevalence is not clearly established and has a range of 5–96% (11,12). Although muscle weakness may be associated with myopathy, it may also be secondary to disuse due to skin thickening and joint contracture (13).…”

Validation of Sonography findings of synovitis and tenosynovitis of hands and wrists in patients with systemic sclerosis

“…Some of our patients had severe hand contractures, preventing full evaluation of all joints but this is inherent in the disease and cannot be avoided. 27 We could not obtain X-ray results for most patients in order to assess erosions. Wakefield et al 28 have found that in early RA patients sonography detected 6.5-fold more erosions than did radiography, in 7.5-fold the number of patients.…”

Inter‐rater reliability of modified hand mobility in scleroderma test

“…mHAMIS is a short, inexpensive and practical test developed to evaluate the hand mobility of patients with SSc . Because of these advantages, it is frequently used in clinical studies including hand‐related evaluations in individuals with SSc …”

“…6 8 Because of these advantages, it is frequently used in clinical studies including hand-related evaluations in individuals with SSc. [9][10][11] Evaluation of the reliability of the tests/scales used in the field of medical rehabilitation is important in terms of their sensitivity to minimal changes in health status and their use in clinical trials.…”