Ultrasound findings in finger flexor tendons in systemic sclerosis: A cross-sectional pilot study

Michael Hughes, Joanne Manning, Tonia Moore, Ariane Herrick, Sarang Chitale

Research output: Contribution to journalArticlepeer-review

23 Downloads (Pure)

Abstract

Objective: Finger flexion contractures are an important cause of disability in patients with systemic sclerosis (SSc); however, their pathophysiology is poorly understood Our aim was to assess feasibility of scanning finger flexor tendons in patients with SSc and explore the ultrasound findings in these tendons, including measurement of finger flexor tendon complex (FFTC).

Methods: Grey Scale and Power Doppler ultrasound assessment of the FFTC including tendon structure and surrounding soft tissue. Measurements of the FFTC (A1 pulley, tendon and palmar plate) were made. Feasibility was assessed by the number of fingers which could be measured.

Results: We studied the second to fifth flexor tendons (n=160) of both hands in 20 patients with SSc, including early and established disease. We were able to assess the FFTC and make measurements of the flexor tendon and palmar plate in all (n=40) and A1 pulley in almost all (n=39) of the studied fingers. Common pathologies identified included peritendinous (n=12) and soft tissue (n=8) calcification. Tendon thickening was seen in 6 patients, but synovitis/tenosynovitis was rare. The A1 pulley was thickened in patients with SSc (0.46mm), in particular, those with diffuse cutaneous SSc (0.50mm).

Conclusion: We were able to successfully assess, including making measurements of, the FFTC in patients with SSc. Our study showed calcifications in the peritendinous areas and soft tissue and thickening of the A1 pulley. These findings may play a role in the pathophysiology of SSc-hand contractures by causing mechanical impingement of the finger flexion mechanism. This pilot study will guide future research to look for potential (treatable) causes of finger flexion contractures in patients with SSc.
Original languageEnglish
Pages (from-to) 77–82
JournalJournal of Scleroderma and Related Disorders
Volume5
Issue number1
Early online date12 Jul 2019
DOIs
Publication statusPublished - 2019

Keywords

  • Systemic sclerosis
  • Scleroderma
  • Ultrasound
  • Flexor tendon
  • Pulley
  • Calcinosis

Fingerprint

Dive into the research topics of 'Ultrasound findings in finger flexor tendons in systemic sclerosis: A cross-sectional pilot study'. Together they form a unique fingerprint.

Cite this