impact factor, citescore
logo
 

Diagnosis

 

Hand ultrasound for the diagnosis of scleroderma: a scoring strategy including US items and items from the EULAR/ACR classification


1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13

 

  1. Department of Rheumatology, CHU Rennes, Université de Rennes, France.
  2. Department of Internal Medicine and Clinical Immunology, CHU Rennes, Université de Rennes; and Université de Rennes, CHU Rennes, Inserm, EHESP, IRSET (Institut de Recherche en Santé, Environnement et Travail) – UMR_S 1085, Rennes, France.
  3. Department of Rheumatology, CHU Rennes, Université de Rennes; and Inserm U 1241, Université de Rennes, France.
  4. Department of Internal Medicine and Clinical Immunology, CHU Rennes, Université de Rennes, France.
  5. Department of Internal Medicine and Clinical Immunology, CHU Rennes, Université de Rennes, France.
  6. Université de Rennes; CHU Rennes, Department of Dermatology; INSERM, CIC 1414, Rennes; REPERES Pharmacoepidemiology and access to Health Care, University Rennes 1 and French School of Public Health, UPRES EA 7449, Rennes, France.
  7. Department of Rheumatology, CHU Rennes, Université de Rennes, France.
  8. Université de Lille, U995, Lille Inflammation Research International Centre; and CHU Lille, Département de Médecine Interne et Immunologie Clinique, Lille, France.
  9. Université de Lille, U995, Lille Inflammation Research International Centre; CHU Lille, Département de Médecine Interne et Immunologie Clinique, Lille; Inserm, Lille; and Centre National de Référence Maladies Systémiques et Auto-Immunes Rares du Nord et Nord-Ouest de France, Lille, France.
  10. Université de Lille, U995, Lille Inflammation Research International Centre; CHU Lille, Département de Médecine Interne et Immunologie Clinique, Lille; Inserm, Lille; and Centre National de Référence Maladies Systémiques et Auto-Immunes Rares du Nord et Nord-Ouest de France, Lille, France.
  11. Department of Internal Medicine and Clinical Immunology, CHU Rennes, Université de Rennes; and Université de Rennes, CHU Rennes, Inserm, EHESP, IRSET (Institut de Recherche en Santé, Environnement et Travail) – UMR_S 1085, Rennes, France.
  12. Department of Rheumatology, CHU Rennes, Université de Rennes; and Inserm U 1241, Université de Rennes, France.
  13. Department of Internal Medicine and Clinical Immunology, CHU Rennes, Université de Rennes; and Université de Rennes, CHU Rennes, Inserm, EHESP, IRSET (Institut de Recherche en Santé, Environnement et Travail) – UMR_S 1085, Rennes, France. alain.lescoat@chu-rennes.fr

CER13501
2020 Vol.38, N°3 ,Suppl.125
PI 0140, PF 0147
Diagnosis

Free to view
(click on article PDF icon to read the article)

PMID: 32865172 [PubMed]

Received: 28/04/2020
Accepted : 06/07/2020
In Press: 27/08/2020
Published: 27/08/2020

Abstract

OBJECTIVES:
To evaluate the diagnostic value of hand ultrasound (US) in systemic sclerosis (SSc) and to explore its relevance within a combined diagnostic approach.
METHODS:
224 patients with suspected SSc were consecutively included. They all had US evaluation assessing the presence of fibrotic tenosynovitis (fibrotic TS) and ulnar artery occlusion (UAO). The final diagnosis of SSc was based on the clinical evaluation of a board of experts independently of any pre-established classification criteria.
RESULTS:
166 patients were finally diagnosed as SSc according to the experts as reference standard. 62 SSc and 8 non-SSc patients had UAO (uni or bilateral) (p=0.001). 23 SSc patients and 1 non-SSc patient had US fibrotic TS (p=0.007). A US SSc-pattern (presence of UAO and/or fibrotic TS) was reported in 73 SSc patients and 9 non-SSc patients (p<0.001). UAO had an area under ROC curve (AUC) for the diagnosis of SSc of 0.618 (95%CI 0.539– 0.697); with Se=0.373 (0.304–0.449) and Sp=0.862 (0.751–0.928). Fibrotic TS had an AUC of 0.561 (0.480–0.643); with Se=0.139 (0.094–0.199) and Sp=0.983 (0.909–0.997). The US-SSc pattern had a AUC of 0.641 (0.563– 0.695), with Se=0.440 (0.367–0.516) and Sp=0.845 (0.731–0.916). A scoring system including these US parameters and items from ACR/EULAR classification criteria had an AUC of 0.979 (0.962–0.996)) and allows the substitution of capillaroscopy by US parameters with similar performances.
CONCLUSIONS:
The use of hand US parameters may help to refine the diagnostic strategy of SSc and their inclusion in a combined diagnostic approach could be discussed.

Rheumatology Article