The value of ultrasound in the diagnosis of limited scleroderma – a case report
Grzegorz Pracoń1, Mateusz Płaza1, Marta Walentowska-Janowicz1, Iwona Sudoł-Szopińska1,2
1 Department of Radiology, Institute of Rheumatology, Warsaw, Poland
2 Department of Diagnostic Imaging, Second Faculty, Warsaw Medical University, Poland
Correspondence: Grzegorz Pracoń, Department of Radiology, Institute of Rheumatology, Spartańska 1, 02-637 Warsaw, Poland, tel./fax: +48 22 844 42 41, e-mail: email@example.com
Systemic sclerosis, popularly referred to as scleroderma, is a chronic connective tissue disease with present autoantibodies against platelet-derived growth factor receptor. These antibodies activate directly fibroblasts causing the dermis and internal organs’ fibrosis and vascular damage. Additionally, calcific collections, including hydroxyapatite crystals, may develop in subcutaneous tissue and juxta-articular soft tissue. Herein, we report a case of a 72-year-old woman, referred by a rheumatologist for plain radiography and ultrasound examination of hands due to pain and swelling of the fourth finger of the left hand. Dermal induration affecting hands, especially fourth finger on the left side and the Raynaud phenomenon were observed on physical examination. Furthermore, the patient had noticed periodic discharge with a toothpaste consistency from a tiny fistula localised in the vicinity of the fourth finger alterations. The paper emphasises a possible application of the twinkling artefact and MicroPure option on ultrasound examination in differential diagnosis of soft tissue calcifications. Making the correct diagnosis can attribute to precise planning of surgical treatment.