Relationship between calcifications and structural lesions on hand radiography and axial calcifications on CT-scan

Abstract

The objectives of this study were to describe the prevalence and characteristics of radiographic lesions of the hands, and calcifications of the spine on computer tomography scans (CT-scans), and to investigate the relationships between radiographic and CT-scan abnormalities and clinical features in a population of patients with systemic sclerosis (SSc). Subjects underwent X-ray examination of the hands, and thoracic or thoraco-abdominal and pelvic CT scan or lumbar CT scan in the year. Structural lesions on hand X ray was scored and spinal calcifications were evaluated in the anterior, intracanal and posterior segments. Intra and inter-reliability was tested for radiography and CT- scan. Prognostic factors considered were interstitial pulmonary lesions on the CT scan, pulmonary arterial hypertension (PAH) and death. This study involved 77 SSc patients, 58 (75%) with limited cutaneous SSc (lcSSc) and 19 (25%) with diffuse SSc (dSSc). The prevalences of radiographic lesions of the hand were 28.6% for periarticular calcifications and 26% for calcinosis. On CT scan, 64 (83%) patients exhibited at least 1 calcification. Spine calcifications were depicted in 80.5%, 27.3%, and 35.1% at the anterior, intracanal and posterior segments respectively. Calcifications were mainly localized on thoracic spine. Inter reader reliabilities were good for hands and moderate for spine respectively. Spine calcifications and periarticular calcifications in the hands were associated ( P = .012). Calcinosis in the hands was related to PAH ( P = .02). Posterior calcification segment and foraminal calcifications were associated with interstitial lung disease (ILD) ( P = .029) and death ( P = .001). More than 80% of systemic sclerosis patients presented spine calcifications. A significant association between hands and spinal calcifications were confirmed and some localization in the posterior segment considered as a bad prognostic factor.

Incidence and prevalence of interstitial lung diseases worldwide: a systematic literature review

“…When assessing SSc ILD prevalence, we observed a wide range (26.1% to 88.1%) 37 44 in reported estimates, but when studies were dichotomised into single-centre studies and multicentre studies, it became clear that the highest variability was contributed by single centre studies (SSc prevalence, 31.2%–88.1%). 43–46 Owing to a smaller number of studies reporting incidence, we were unable to observe whether the same challenge existed.…”

Calcinosis in Rheumatic Disease Is Still an Unmet Need: A Retrospective Single-Center Study

“…Univariate analysis revealed that calcinosis patients exhibited a higher proportion of severe organ involvement, particularly in vascular and GI disease. Other clinical features did not significantly correlate with the calcinosis subset in SSc, although recent research suggests a positive link between subcutaneous calcinosis at disease onset and the presence of pulmonary arterial hypertension [ 42 ]. SSc patients had a higher frequency of DU history, which aligns with the proposal of a link between calcinosis and vasculopathy by Avouac et al, as their patient population with calcinosis was more likely to have a history of DU [ 4 ].…”

Calcinosis in systemic sclerosis

“…Unusual locations like the spine or face are reported in some studies [15][16][17][18]20]. Spinal calcinosis, which was found to occur commonly in association with acral calcinosis [21], can lead to radiculopathy, spinal stenosis, or cord compression [15][16][17][18]21,22].…”