Name : Morteza
Family : Sanei Taheri
Resident : Dr.Ghofrani
Gender : Female
Age : 39
Imaging Procedures and Findings
The PA radiograph of both hands shows juxta-articular osteopenia, arthritic changes in DIPs, both radiocarpal and carpal joints more marked on the right side with erosion at lateral side of the 3rd right middle phalanx and left ulnar styloid. The left 5th PIP joint seems to be subluxed. Soft ??tissue calcification is also noted.
In systemic sclerosis, fibrosis of the skin especially over distal phalanges leads to resorption of the distal and then progressively of the middle and proximal phalanges. Soft-tissue calcification-typically subcutaneous - is seen, especially over distal phalanges and around joints. These changes may be preceded or accompanied by a polyarthritis similar to rheumatoid arthritis in at least 10% of patients. Osteoporosis, joint space narrowing, erosions and subluxations may be seen. Changes of an erosive arthropathy in association with calcification should suggest the presence of progressive systemic sclerosis.
1- Sutton D. Textbook of radiology and Imaging. 7th edition, 2003 2- Brant WE, Helms CA. Fundamentals of diagnostic Radiology. 3rd edition, 2007