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Background: Articular involvement is frequent in Systemic Sclerosis. Joint symptoms have been noted in 24-97% of patients at some time during the course of their illness. Musculoskeletal Ultrasound and Magnetic Resonance Imaging can identify and characterize subclinical synovial inflammation as well as overt joint damage in Systemic Sclerosis. Aim of Study: To evaluate the role of Musculoskeletal Ultrasound and Magnetic Resonance Imaging in early detection of inflammatory arthropathy in patients with Systemic Sclerosis and to correlate the radiological findings with various disease parameters. Patients and Methods: 20 patients with Systemic Sclerosis and arthralgia, with no evidence of clinical or laboratory features of overlap syndromes (including Rheumatoid Factor or Anti CCP) or evidence of clinically swollen or tender joints, were subjected to clinical and immunological evaluation. Musculoskeletal ultrasonography and Magnetic resonance imaging were done for tenosynovitis, synovitis and erosions, with MRI representing the standard reference method. Results: Musculoskeletal ultrasound detected tenosynovitis in 55%, synovitis in 50% and erosions in 35% of patients as compared to Magnetic resonance which detected tenosynovitis in 80%, synovitis in 75% and erosions in 55% of the patients with a percentage of agreement of 72%, 64% and 60% for tensosynovitis, synovitis and erosions respectively. Tenosynovitis and synovitis showed a significant positive correlation with ESR (r=0.44) and CRP (r=0.53) and erosions correlated significantly with the disease duration (r=0.63). Conclusion: Inflammatory arthropathy and erosive changes are present in a high percentage of systemic sclerosis patients. Tenosynovitis and synovitis correlate with systemic inflammatory markers. Both musculoskeletal ultrasound and magnetic resonance imaging are useful in characterizing early inflammatory arthropathy in systemic sclerosis patients. [Egypt J Rheumatology & Clinical Immunology, 2015; 3(1): 39-45]

Musculoskeletal Ultrasonography and Magnetic Resonance Imaging in Early Detection of Inflammatory Arthropathy in Patients with Systemic Sclerosis