A narrative review of imaging in calcinosis associated with systemic sclerosis

Mar, Diane; Valenzuela, Antonia; Stevens, Kathryn J.; Chung, Lorinda; Fairchild, Robert

doi:10.1007/s10067-021-05696-6

Cited by 14 publications

(17 citation statements)

References 61 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Radiographs allow rating of calcinosis and a description of the morphological pattern, such as nodular, sheet-like, reticular, amorphous, and linear [40]. By HUS, which is a low-cost, point of care, nonionizing imaging modality, calcinosis is described as hyperechoic foci with or without acoustic shadowing, which may increase detection, but may be more time intensive and is dependent on sonographer experience with less reproducibility [39 ▪ ]. The addition of Doppler imaging modes can result in artifact [41].…”

Section: Imaging Of Calcinosismentioning

confidence: 99%

“…Radiography, high-frequency ultrasound (HUS), computed tomography (CT), positron emission tomography (PET), and magnetic resonance imaging (MRI) can be used to quantify the vascular complication of calcinosis [38,39 ▪ ]. Radiographs and HUS are the least expensive options for following calcinosis lesions.…”

Section: Imaging Of Calcinosismentioning

confidence: 99%

“…Without the PET component, traditional CT can provide information regarding adjacent anatomic structures, which can guide a surgical approach to management [44]. Novel CT approaches, such as 3D visualization and dual-energy, provide better visualization, but are limited for serial use by cost and radiation exposure [39 ▪ ]. MRI with high contrast resolution and multiplanar imaging effectively evaluates soft tissue pathology without associated radiation exposure, but cost limits feasibility.…”

Section: Imaging Of Calcinosismentioning

confidence: 99%

See 2 more Smart Citations

Imaging techniques for assessment of vascular involvement in systemic sclerosis

Frech

2022

Current Opinion in Rheumatology

View full text Add to dashboard Cite

Purpose of reviewVascular assessment in systemic sclerosis (SSc) is included in classification criteria for this disease, thus routinely used in the evaluation of patients in which this diagnosis is being considered. In this review, imaging techniques for assessment of vascular involvement in SSc hands and skin are discussed. Recent findingsLongitudinal use of imaging techniques has important implications for understanding the progressive vasculopathy and fibrotic transition in SSc. Nailfold and oral capillaroscopy as well as laser speckle contrast analysis are established techniques for vascular functional assessment, but longitudinal use is challenged by equipment costs and clinical time constraints. Ultrasound techniques are well described but require technical training. Advances in mobile infrared thermography and optical coherence tomography could potentially provide a point-of-care, quantitative outcome measure in clinical trials and practice.

show abstract

Section: Imaging Of Calcinosismentioning

confidence: 99%

Section: Imaging Of Calcinosismentioning

confidence: 99%

Section: Imaging Of Calcinosismentioning

confidence: 99%

See 1 more Smart Citation

Imaging techniques for assessment of vascular involvement in systemic sclerosis

Frech

2022

Current Opinion in Rheumatology

View full text Add to dashboard Cite

show abstract

“…Although computed tomography (CT) is more sensitive than X-rays and provides information on surrounding structures such as neurovascular bundles [56 ▪ ], radiographic estimation of calcinosis volume seems to correlate well with that of CT [57]. Artificial intelligence is being applied to dual energy CT scans in SSc patients with calcinosis of the fingers to more accurately estimate calcinotic burden, but further validation studies are necessary [58,59].…”

Section: Diagnostic Modalitiesmentioning

confidence: 99%

Calcinosis in systemic sclerosis

Davuluri

Lood

Chung

2022

Current Opinion in Rheumatology

Self Cite

View full text Add to dashboard Cite

Purpose of reviewThe aim of this study was to provide updated information on the prevalence, pathogenesis, diagnostics and therapeutics of calcinosis cutis associated with systemic sclerosis (SSc).Recent findingsObservational studies show ethnic and geographical differences in the prevalence of calcinosis. In addition to clinical and serological associations, biochemical studies and in-vivo models have attempted to explain theories behind its pathogenesis, including prolonged state of inflammation, mechanical stress, hypoxia and dysregulation in bone and phosphate metabolism. Long-term use of proton pump inhibitors may increase the risk for calcinosis in SSc. Few single-centre observational studies have shown mild benefit with minocycline and topical sodium thiosulfate.SummaryCalcinosis cutis is the deposition of insoluble calcium in the skin and subcutaneous tissues. It affects up to 40% of SSc patients and causes significant morbidity. Long disease duration, features of vascular dysfunction and osteoporosis have been associated with calcinosis. Altered levels of inorganic pyrophosphate and fibroblast growth factor-23 have been implicated in dysregulated phosphate metabolism that may lead to calcinosis in SSc. Plain radiography can help with diagnosis and quantifying the calcinosis burden. Surgical treatment remains the most effective therapy when feasible. At present, no medical therapies have proven efficacy in large randomized controlled trials.

show abstract

“…3 Given its low cost and comparable information to 3-D modalities, plain radiography is the initial imaging of choice for calcinosis. 4 Currently, there are no approved treatments for calcinosis in patients with SSc. Several pharmacologic therapies have been tried in small case series with disappointing or modest results, and surgical excision of calcium deposits remains the mainstay of treatment.…”

mentioning

confidence: 99%