Articular involvement in systemic sclerosis

Abstract

Articular involvement is frequent in SSc. It contributes to disability and compromises patients' quality of life. Different aspects of articular involvement have been described, ranging from arthralgia and arthritis to joint contracture and tendon sheath involvement. Recent cohort studies examining clinical and radiographic aspects of SSc have clarified the frequency of articular involvement and identified subsets of SSc patients with a higher risk of developing joint involvement. They have also highlighted the potential contribution of inflammatory arthritis to early SSc. Some pilot studies have underlined the potential usefulness of new imaging tools, such as ultrasonography and MRI for a better evaluation of joint involvement in SSc. Current treatment strategies for SSc-related inflammatory joint disease have not been evaluated in randomized controlled trials and generally derive from RA. MTX associated with low-dose CSs is the standard care for arthritis. Other treatment strategies (LEF and i.e. biologics borrowed from RA) may bring new opportunities to treat SSc-related arthritis and even SSc per se. However, the first step will be to study and validate outcome criteria in this insufficiently studied field.