Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Jul;8(2):e002371.
doi: 10.1136/rmdopen-2022-002371.

Recommendations for the execution and reporting of skin ultrasound in systemic sclerosis: an international collaboration under the WSF skin ultrasound group

Tânia Santiago  1   2 , Eduardo José Ferreira Santos  3 , Barbara Ruaro  4 , Gemma Lepri  5   6 , Lorraine Green  7 , Marie Wildt  8 , Shinji Watanabe  9 , Alain Lescoat  10 , Roger Hesselstrand  8 , Francesco Del Galdo  11   12 , John D Pauling  13   14 , Lucy Jean Reeve  15 , Maria Antonieta D'Agostino  16   17 , Marco Matucci-Cerinic  5   6 , Annamaria Iagnocco  18 , Jose Antonio Pereira da Silva  19   20
Affiliations

Recommendations for the execution and reporting of skin ultrasound in systemic sclerosis: an international collaboration under the WSF skin ultrasound group

Tânia Santiago et al. RMD Open. 2022 Jul.

Abstract

Objective: Ultrasound is a promising tool to foster much-needed improvement of skin assessment in systemic sclerosis (SSc). Our aim was to develop evidence and expert opinion-based recommendations to promote the standardisation and harmonisation of technical execution and reporting of skin ultrasound studies in SSc.

Methods: A multidisciplinary task force of 16 members from five European countries and Japan was convened under the auspices of World Scleroderma Foundation. First, a systematic literature review (SLR) was performed. Then, each member proposed and formulated items to the overarching principles, recommendations and research agenda. Two rounds of mails exchange for consensus as well as an on-line meeting were performed to debate and refine the proposals. Two Delphi rounds of voting resulted in the final recommendations. Levels of evidence and strengths of recommendations were assigned, and task force members voted anonymously on the level of agreement with each of the items.

Results: Five overarching principles and seven recommendations were developed, based on an SLR and expert opinion, through consensus procedures. The overarching principles highlight the promising role of skin ultrasound in SSc assessment, the need for standardisation of technical aspects, sufficient training and adequate equipment. The recommendations provide standards for the execution and reporting of skin ultrasound in SSc. The research agenda includes the need for more research into unmet needs according to Outcome Measures in Rheumatology Algorithm requirements.

Conclusion: These are the first recommendations providing guidance on the execution and reporting of skin ultrasound in SSc patients, aiming at improving the interpretability, reliability and generalisability of skin ultrasound, thus consolidating its role in research and practice.

Keywords: Outcome and Process Assessment, Health Care; Scleroderma, Systemic; Ultrasonography.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

References

    1. Krieg T, Takehara K. Skin disease: a cardinal feature of systemic sclerosis. Rheumatology 2009;48 Suppl 3:iii14–18. 10.1093/rheumatology/kep108 - DOI - PubMed
    1. Clements PJ, Hurwitz EL, Wong WK, et al. . Skin thickness score as a predictor and correlate of outcome in systemic sclerosis: high-dose versus low-dose penicillamine trial. Arthritis & Rheumatism 2000;43:2445–54. 10.1002/1529-0131(200011)43:11<2445::AID-ANR11>3.0.CO;2-Q - DOI - PubMed
    1. Khanna D, Furst DE, Clements PJ, et al. . Standardization of the modified rodnan skin score for use in clinical trials of systemic sclerosis. J Scleroderma Relat Disord 2017;2:11–18. 10.5301/jsrd.5000231 - DOI - PMC - PubMed
    1. Merkel PA, Clements PJ, Reveille JD, et al. . Current status of outcome measure development for clinical trials in systemic sclerosis. report from OMERACT 6. J Rheumatol 2003;30:1630–47. - PubMed
    1. Khanna D, Lin CJF, Furst DE, et al. . Tocilizumab in systemic sclerosis: a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet Respir Med 2020;8:963–74. 10.1016/S2213-2600(20)30318-0 - DOI - PubMed

Publication types