Musculoskeletal ultrasound of the shoulder in systemic sclerosis

Abstract

Objectives: To explore shoulder findings by ultrasonography and to find factors associated with shoulder ultrasonographic abnormalities in systemic sclerosis patients.

Methods: A series of systemic sclerosis patients who attended the scleroderma clinic, Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Thailand, were prospectively evaluated for baseline characteristics, physical examination, and ultrasonography of both shoulders.

Results: Seventy-four systemic sclerosis patients were enrolled in this study. Diffuse cutaneous type of systemic sclerosis was the most common type (62.2%). The three common systemic sclerosis-associated symptoms were skin tightness (28.5%), salt-pepper appearance (20.9%), and telangiectasia (11.6%). The prevalence of shoulder pain in systemic sclerosis patients was 43.2% (32/74). Sixty-eight patients (92%) had abnormal ultrasonographic findings. The most common ultrasonographic abnormalities were unilateral calcification inside the glenohumeral joint (45.9%), bilateral calcification inside the glenohumeral joint (36.5%), and bilateral supraspinatus tendinosis (28.9%). Skin edematous was the only factor associated with abnormal shoulder ultrasonographic findings. No association between shoulder pain and abnormal shoulder ultrasonographic findings was detected.

Conclusion: Ultrasonographic abnormalities in the shoulder were common in the systemic sclerosis patients. The most frequent ultrasonographic finding of shoulder joints in systemic sclerosis patients was calcification inside the glenohumeral joint. Moreover, asymptomatic shoulder ultrasonographic abnormalities were prevalent in individuals with systemic sclerosis.

Keywords: Systemic sclerosis; calcification; shoulder pain; supraspinatus tendinosis; ultrasonography.

Figure 1.

Calcification in glenohumeral joint.