Evaluation of the chronic pathologies in terminal phalanges of scleroderma patients by plain radiographs

Year 2018, Volume: 11 Issue: 3, 336 - 341, 25.12.2018

Mehmet Ercüment Döğen , Ümit Yaşar Ayaz

https://doi.org/10.26559/mersinsbd.460823

Abstract

Purpose: We aimed to reveal terminal phalangeal
changes in scleroderma patients by direct radiography.

 

Materials and methods:
Bilateral hand-wrists radiographs of eight women
with a mean age of 36.4 years (range, 22-48 years) who were on follow-up with
the diagnosis of scleroderma were retrospectively evaluated for acral (terminal
phalanx) pathologies and other hand-wrist changes.

 

Results

On bilateral hand-wrist radiographs,
flexion contractures with different degrees in 62.5% (n=5/8) of cases,  claw hand and claw hand development process
in 25% (n=2/8) of cases, arthritic and degenerative changes in various
localizations of the  intercarpal ,
carpometacarpal, metacarpophalangeal and interphalangeal joints in  75% (n=6/8) of cases, various degrees of
periarticular osteoporosis were observed. In 25% (n=2/8) of cases, soft tissue
calcifications were detected distal to the fingers. Terminal phalanx resorption
(acroosteolysis) and erosion were observed in 62.5% (n=2/8) cases. It has been
determined that these periosteal resorption and erosions are more likely to
affect the palmar sides of the taft. Acroosteolysis was milder and more limited
in the two cases, and in the three cases, the terminal phalanges were seen as
prominent cusps.

 

Conclusion: Direct
radiography has been found to be useful in showing terminal phalange
pathologies, especially acroosteolysis in chronic scleroderma cases, and this
should be the first imaging method to be applied.

Keywords

Scleroderma, acro-osteolysis, radiography, wrist

Skleroderma olgularında ellerde oluşan kronik terminal falanks patolojilerinin direkt radyografi ile değerlendirilmesi

Abstract

Amaç: Skleroderma olgularındaki terminal falanks
değişikliklerini direkt radyografi ile ortaya koymayı amaçladık. Yöntem: Skleroderma tanısı ile izlenen
ve yaş ortalaması 36.4 yıl olan (aralık, 22-48 yıl), hepsi kadın sekiz olgunun
el-el bilek radyografileri akral (terminal falanks) patolojileri ve diğer el-el
bileği değişiklikleri yönünden retrospektif olarak incelendi. Bulgular: Bilateral el-el bileği
radyografilerinde olgularının 5’inde (%62.5) değişik derecelerde fleksiyon
kontraktürleri ve 2’sinde (%25.0) pençe el-pençe el gelişim süreci, 6’sında
(%75.0) interkarpal, karpometakarpal, metakarpofalangeal ve interfalangeal eklemlerde
değişik lokalizasyonlarda ve derecelerde artritik ve dejeneratif değişiklikler,
değişik derecelerde periartiküler osteoporoz izlendi. Olguların 2’sinde (%25.0),
parmakların distalinde yumuşak doku kalsifikasyonları saptandı. Olguların
5’inde (%62,5) değişik derecelerde terminal falanks rezorpsiyonları
(akroosteoliz), erozyon görüldü. Bu periosteal rezorpsiyon ve erozyonların,
taftların palmar taraflarını daha çok etkilediği saptandı.  Olguların
2’sinde (%25.0) akroosteoliz daha hafif ve sınırlı olup, 3’ünde  (%37.5)
terminal falankslarda belirgin sivrileşmeler şeklinde görüldü. Sonuç: Direkt radyografi, kronik
skleroderma olgularında başta akroosteoliz olmak üzere terminal falanks
patolojilerini göstermede yararlı bulunmuş olup bu konuda başvurulacak ilk
görüntüleme yöntemi olmalıdır.

Keywords

Skleroderma, akroosteoliz, radiografi, elbilek

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