A three-year follow-up study of the development of joint contractures in 131 patients with systemic sclerosis

CER7096
2014 Vol.32, N°6 ,Suppl.86
PI 0068, PF 0074
Clinical aspects

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

PMID: 25152080 [PubMed]

Received: 09/11/2013
Accepted : 19/03/2014
In Press: 04/08/2014
Published: 03/11/2014

Abstract

OBJECTIVES:
To analyse the correlation between the number of joint-contractures and other major clinical findings in a follow-up study of 131 patients with systemic sclerosis (SSc).
METHODS:
The range of motion of joints (ROM), HAQ-DI, and the major clinical characteristics were assessed.
RESULTS:
A high frequency of contractures (ROM<75% of the normal) were present at baseline in small joints of the hand (82%), wrists (75%), and shoulders (50%). ROM of the dominant side hand was significantly more decreased compared to the non-dominant side. The number of the upper extremity contractures correlated positively with ESR (p<0.01), CRP (p<0.01), HAQ-DI (p<0.01), and negatively with forced vital capacity (FVC) (p<0.05). The number of contractures was not significantly different in cases with early (≤4 years) and late disease duration in both the limited and diffuse subgroups. During the three-year follow-up period, an increase in the number of joint contractures (ROM<75%) was associated with an increase of ESR, modified Rodnan`s skin score, and the European Scleroderma Study Group Activity Index by multiple linear regression analysis. Univariate analysis over a six-year period demonstrated poor outcome in patients with more than ten contractures, or more than four contractures of unilateral hand-joints.
CONCLUSIONS:
Contractures predominantly develop during the early years following disease onset in both SSc subgroups. Inflammation and skin-involvement are significant contributing factors for the development of contractures. The dominant hand may be more pronouncedly impaired compared to the non-dominant side. A high number of joint-contractures might be an unfavourable prognostic factor in SSc.