Scleroderma

Case contributed by Mohamad Alfared
Diagnosis certain

Presentation

Bilateral hand and wrist pain. Epigastric pain. Known case of scleroderma.

Patient Data

Age: 20 years
Gender: Female
x-ray

Bilateral tuft resorption is associated with fingertip soft tissue atrophy and peri-articular osteopenia. No abnormal soft tissue calcification.

Case Discussion

Scleroderma is an autoimmune disease characterized by multisystem fibrosis and soft tissue calcification.

The hands are the most common site of musculoskeletal involvement and characterized by:

  • acro-osteolysis (resorption of distal phalanx)
  • periarticular osteopenia
  • joint space narrowing
  • bony erosions
  • subcutaneous and periarticular calcification 
  • atrophy of the fingertips
  • hand deformity (flexion contractions)

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