Imaging in early diagnosis of systemic sclerosis. Clinical case report

Authors

  • Katia Melanie Camargo-Ibarias División de Enfermedades Musculoesqueléticas y Reumáticas. Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Ciudad de México, México.
  • Carlos Pineda-Villaseñor División de Enfermedades Musculoesqueléticas y Reumáticas. Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Ciudad de México, México.
  • Carlos Alberto Lozada-Pérez División de Enfermedades Musculoesqueléticas y Reumáticas. Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Ciudad de México, México.
  • Chiara Bertolazzi-Pagliari División de Neurociencias. Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Ciudad de México, México.
  • Marwin Gutiérrez División de Enfermedades Musculoesqueléticas y Reumáticas. Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Ciudad de México, México.
  • Alfonso Benito Alfaro-Rodríguez División de Neurociencias. Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Ciudad de México, México.
  • María Fernanda González-Hernández División de Enfermedades Musculoesqueléticas y Reumáticas. Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Ciudad de México, México.

Keywords:

Systemic sclerosis, ultrasound, capillaroscopy, early diagnosis

Abstract

Systemic sclerosis is a disease of connective tissue where there is an overproduction of extracellular matrix, which causes fibrosis in the skin and other organs. It is characterized by vascular dysfunction and alterations in the microvasculature. The clinical manifestations can be very
variable during their evolution, integrating these clinical data with the use of new technologies
such as capillaroscopy and ultrasound can detect the disease early without the progression of
the disease .The present case report corresponds to a 65 years old female patient, who is
referred for suspicion of polymyalgia rheumatica. After the interrogation, an asymmetric Raynaud phenomenon and pain at carpal and metacarpophalangeal level was evidenced. Ultrasound (US) was performed in those joints finding chronic synovitis associated with tenosynov itis, and early scleroderma pattern in nailfold capillaroscopy was also shown. The immunological profile was requested obtaining positive antibodies (SCL 70 and ANAs). Subsequently B
lines were found in the pulmonary US. For all of the above, the diagnosis of Systemic Sclerosis (SS) was reached and treatment was started. We conclude that the support of different
imaging methods such as musculoskeletal ultrasound and nailfold capillaroscopy are fundamental for the diagnosis of early SS.

References

Denton, C. P., & Khanna, D. Systemic sclerosis. The Lancet. 2017.

Vera O, Esclerosis sistémica. Med Int 2006;

; 231-45.

Barns J, Mayes M, Epidemiology of systemic

sclerosis: incidence, prevalence, survival, risk

factors, malignancy and environmental triggers. Curr Opin Rheumatol. 2012; 24(2): 165-

Diagnóstico, Tratamiento y Pronóstico de la

Esclerosis Sistémica. México: Secretaria de

Salud, 2010.

Desbois AC, Cacoub P. Systemic Sclerosis: An

update in 2016. Autoimmunity reviews 2016;

; 417-426.

Van den Hoogen, et al. 2013 Classification

Criteria for Systemic Sclerosis. Arthritis and

Rheumatism. 2013; 65 (11) 2737-2747.

Avouac J Fransen J, Walker UA, Riccieri V,

Smith V, Muller C, et al. Preliminary criteria for

the very early diagnosis of systemic sclerosis:

results of a Delphi Consensus Study form EULAR Scleroderma Trials and Research Gruop.

AnnRheum Dis 2011;70:476-481.

Cutolo, M., Cerinic, M. Nailfold capillaroscopy

and classification criteria for systemic sclerosis.

Clinical and experimental rheumatology, 2007;

(5), 663-65.

Gutierrez M, Pineda C, Cazenave T, Piras M,

Erre GL, Draghessi A, et al. Ultrasound in systemic sclerosis. A multi-target approach from

joint to lung. Clin Rheumatol 2014; 33:1039-

Cutolo, M., Cerinic, M. Nailfold capillaroscopy

and classification criteria for systemic sclerosis.

Clinical and experimental rheumatology, 2007;

(5), 663-65.

Abeygunaratne, T, Herrick A, Chinoy H,

Sowden E, Choudhury J, Sinha S. Simple tool

in a complex case: use of the nailfold capillaroscopy, Kidney International, 2016; (89)1168.

Clements P, Allanore Y, Furst DE, Khanna D.

Points to consider for designing trials in systemic sclerosis patients with arthritic involvement. Rheumatology (Oxford). 2017 Sep 1;

(suppl_5):v23-v26

Published

2024-07-12

How to Cite

1.
Camargo-Ibarias KM, Pineda-Villaseñor C, Lozada-Pérez CA, Bertolazzi-Pagliari C, Gutiérrez M, Alfaro-Rodríguez AB, et al. Imaging in early diagnosis of systemic sclerosis. Clinical case report. InDiscap [Internet]. 2024 Jul. 12 [cited 2024 Nov. 14];7(2):67-71. Available from: https://dsm.inr.gob.mx/indiscap/index.php/INDISCAP/article/view/107

Issue

Section

Case reports and case series

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